Over the past decade, as healthcare has shifted toward value-based care, there has also been a movement away from single-condition disease management toward whole-person population health management. Seeing this shift, as well as regulatory changes, new technologies and care models, the National Committee for Quality Assurance (NCQA) transitioned its Disease Management Accreditation program to Population Health Management Accreditation. Health Dialog was awarded the new Population Health Management Accreditation for its Chronic Care Management solution after holding the previous Disease Management Accreditation for 18 years.
What is Population Health
Health Dialog pioneered the concept of whole-person population health management more than 20 years ago; before it became the industry buzzword it is today. Many organizations have taken on the moniker to attract attention, leading to a lot of interpretations and definitions that sometimes stretch what it truly means to deliver such services.
According to NCQA, a private, non-profit organization dedicated to improving healthcare quality that accredits and certifies a wide range of healthcare organizations:
Population health management is a model of care that strives to address patients’ health needs at all points along the continuum of care, including the community setting, by increasing patient participation and engagement and targeting interventions. The goal is to maintain or improve physical and psychosocial wellbeing and address health disparities through cost-effective, tailored health solutions.
NCQA’s Population Health Management Accreditation ensures an organizations’ operations align with the industry’s best population health management practices.
How Population Health Management Differs from Disease Management
A major difference between disease management and population health management is disease management only addresses the patient’s particular condition, whereas population health looks at the whole person. For example, if a patient has diabetes, caring for them using a disease management framework would predominantly focus on getting the person’s A1C to a healthy level and managing their diet and exercise. When using a whole-person population health approach, the clinician would dive much deeper, determining what works best for the patient, what challenges they have, what can be done from a lifestyle- and behavior-change perspective, as well as the impacts of the individual’s community, living circumstances, and geographic location, known as social determinants of health.
When thinking about a patient from a whole-person perspective, you gain a better understanding of their day-to-day life and create a more effective, patient-centered care plan. And greater success at the individual level leads to greater success at the population level.
Another key difference is the timing associated with delivering care. Since population health management isn’t just about treating the condition, the goal is to find patients before they even develop a disease or right at the onset of the condition to try to mitigate future health complications. Traditional disease management often focuses on patients after they are much further along in their disease progression, and the focus is on how to mitigate costs associated with that person’s care. Population health management invests more in prevention.
The Measure of a Quality Population Health Management Program
NCQA’s Population Health Management Accreditation provides a framework for organizations to standardize care, become more efficient and manage complex needs better. This helps keep members healthier, reduce risks and prevent unnecessary costs from poor care management. The rigorous accreditation process evaluates an organization’s data integration, population assessment and segmentation, targeted interventions, practitioner support, and measurement and quality improvement.
Earning this accreditation is a testament to Health Dialog’s longstanding commitment to a whole-person, population health management approach.