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Pankaj Patel MD MSc

Obesity Awareness Symposium: Advocate’s Approach to Population Health Management October 25 th 2013. Pankaj Patel MD MSc Senior Medical Director, Quality Improvement Advocate Physician Partners and Advocate Medical Group.

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Pankaj Patel MD MSc

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  1. Obesity Awareness Symposium: Advocate’s Approach to Population Health Management October 25th 2013 Pankaj Patel MD MSc Senior Medical Director, Quality Improvement Advocate Physician Partners and Advocate Medical Group

  2. “Knowing is not enough, we must applyWilling is not enough, we must do” Goethe

  3. Market Trends and Health Reform: It’s A New Day • Pressure on Commercial Payers • Medicare Insolvency • Medical Inflation>Economic Inflation • Population Aging and Uninsured • ‘Tragedy of the Commons’ Population Health Patient Experience Cost Per Capita

  4. Insurers Acknowledge Difficulty in Controlling… • Utilization of High End Imaging • Readmissions • Outpatient Trend • New Drugs & Technologies • Ambulatory Sensitive Conditions

  5. Options • Reduce Unit Price • ACO with aligned incentives to pursue ‘Triple Aim’ Population Health Patient Experience Cost Per Capita Pankaj Patel

  6. Value Based Agreements ACO=Accountable Care Organization 14

  7. Population Health Management Low Volume/High Dollar Complex CM High Volume/Low Dollar Acute Disease Management Chronic PCP Practice Behavioral Health Team Model Of Care Medical Home Data/Analytics Health Risk Appraisal Claims Data Risk Stratification

  8. Obesity: • Impact on Population Health • BMI>30 results in 200-300% increase in Mortality • Increase in HTN, DM, CVD, DJD • 36% increase in Medical costs • Gluttony or Sloth or Both • Imbalance: Energy consumed and Used • BMJ 1995 Energy consumed declining but obesity increasing

  9. Evolution of Clinical Integration 5 Performance Domains: • Chronic Disease Care • Health and Wellness • Efficiency • Care Coordination • Patient Experience Incentives For All Physicians: Move from pay for performance to pay for value contribution Value Contribution = Performance x Volume of patients managed x Coordination of Care factor

  10. Obesity Related Measures • 2012 • BMI Assessment • 2013 • BMI Assessment and Follow Up • 2015?

  11. Summary • Emerging payment models create a focus on population health management • Population health requires • A new focus on wellness and health status • A team approach

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