Putting the puzzle pieces together: Adapting a population health infrastructure to Medicaid risk

Publication date: Available online 12 February 2020Source: HealthcareAuthor(s): Alex Sheff, Amy Flaster, Sreekanth Chaguturu, Eric WeilAbstractAs Accountable Care Organizations (ACOs) become more common within state Medicaid programs, health systems are increasingly facing the challenge of developing a population health approach for this population. This case report considers how health systems with a mature population health infrastructure evolve, adapt, and expand programs to take on Medicaid risk and better serve the Medicaid population. Four key implementation lessons were garnered from Partners HealthCare's experience that may be relevant for organizations undergoing similar transformations: 1) A significant portion of a health system's existing population health strategy can be applied to the Medicaid risk population; 2) Leveraging existing population health infrastructure can assist in adapting and adding programs; 3) Additional attention needs to be paid to behavioral health, substance use, and social determinants of health needs across existing and new programing; 4) Patients need to be engaged outside of the traditional primary care setting, including in the emergency department, and through home and community based care.
Source: Healthcare - Category: Middle East Health Source Type: research