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Access, Affordability and Quality

There’s a new approach to health care called population health management that explores the health of groups of people by disease status, location, ethnicity, or health risk factors. Access, affordability and quality all rank high on the priority list.
Anne Hewitt, professor of health-care administration, wrote a textbook for graduate students on the subject in 2022, and one for undergraduates will be available this fall. Seton Hall magazine editor Pegeen Hopkins talked to her to learn more.

What is population health management (PHM)?

PHM builds on the idea of population health, which means transitioning from one-patient-at-a-time treatment to improving the health of all Americans. PHM makes health care more clinically effective, cost-effective and safer, and provides the right care, at the right time, by the right provider, at the right place, and with the best outcome.

When did it come into practice?

Since the Affordable Care Act was passed in 2010, health care has expanded how services are delivered. It’s more patient-centric and consumer-friendly. It’s about knowing who a patient needs to see and making sure that person is conveniently accessible. PHM identifies the most vulnerable populations and matches care with need.

Has this changed who’s on a person’s healthcare team?

Population health has expanded care beyond the doctor’s office, the hospital and the nursing home. Now, health promotion and disease prevention are integrated within a patient’s lifestyle, along with options such as remote monitoring via wearables, smartphone messaging and telehealth visits. That’s at the front end of the care continuum. At the back end, we have rehabilitation facilities, palliative care and assisted care homes — not just nursing homes. We’re beginning to see hospital-at-home programs in addition to hospice care.

What makes population health important?

PHM emphasizes quality, convenience, and accountability by reducing the redundancy of going to one specialist after another and creating care coordination plans. Let’s say you need a hip replacement and visit your primary doctor. You would probably be referred to an orthopedist, which would be followed by surgery and a hospital stay. Post-surgery you would return to the orthopedist, along with receiving physical therapy treatment. With PHM, all these interactions are bundled together; it’s a seamless way to receive your care.

Access is also expanding significantly for uninsured or underinsured Americans. If people are eligible for care, they will see the doctor before it’s necessary to visit the emergency room by ambulance. Seniors receiving Medicare also now have a free annual wellness visit, which has produced wonderful outcomes.

How is population health management being taught?

At Seton Hall, a PHM course is part of the master’s in healthcare administration, and we have a separate graduate certificate in population health that covers accountable care organizations, risk segmentation, and new financial models, as well as health promotion, consumerism and behavior economics. Health professional students will learn which subpopulations are at risk. What are the risk factors? What kinds of health care do they need that others don’t?

What else is important for people to know?

Health care is one of the largest industries in the country, and PHM remains extremely complex. Today’s health professionals are committed to making sure everyone receives quality health care. No one should be overlooked, and there’s no excuse for the disparities that continue, especially for minority populations.

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