Consider post-election prospects for population health management

A key campaign message of President-elect Donald Trump was a full repeal of “Obamacare.” While he has recently softened his position–noting that he wants to preserve the popular prohibition against pre-existing conditions and maintain coverage for dependents to age 26–many in the health and behavioral healthcare fields are rightfully anxious about what the future holds.

It’s not possible to fully predict what will happen to the Affordable Care Act, Medicare, Medicaid and other federal health programs under the Trump administration. Obamacare will give way to TrumpCare, but the details are still too speculative.  However, population health management—the focus on systematic efforts to improve health outcomes in subpopulations that share multiple clinical and social attributes—will remain an important part of any new healthcare landscape.

Emphasis on cost savings, quality, and outcomes

Regardless of how people are insured in the future (i.e., through Medicaid, employer sponsored plans, or via the exchange) attention is sure to remain on saving money and improving quality. This will be seen through continued attention on:

• Individuals with chronic conditions: People with chronic conditions account for 86% of the nation’s healthcare costs. The healthcare system will continue to try to find ways to do a better job with these individuals through care coordination, improved outcomes, and reduced costs.
• Data: In order to produce a better healthcare system—whatever that ultimately looks like—we need to be able to identify and analyze information on populations, outcomes, quality, and costs.
• Organized and integrated delivery systems: These systems of care, which share some financial risk with providers and include accountable care organizations and collaborative care organizations, will continue to be the standard business model for healthcare delivery.

Implications for behavioral healthcare providers

What can you do to ensure your success in the new healthcare environment? The following are some key steps.

• Know your data. Data is king in a population health approach to behavioral healthcare. Gain as much knowledge and insight as possible in health information technology and data analytics and reporting. This will put you one step ahead when these become required of your business in new, more stringent, ways.
• Network within leading systems of care. Try to involve your practice in organized delivery systems, and develop strategies for integration with hospitals and other specialty providers for the purpose of treating multiple chronic conditions.
• Identify your niche and sell it. Decide what your expertise is in a population health approach to behavioral healthcare, and then get out here and market yourself as an expert in this field. Look around at what is lacking in your area (such as specialty substance abuse services for pregnant women, for example) and build business around it. Many hospitals and large providers have cited a lack of referral resources and partners among behavioral health providers. You can become that partner.

Any new administration brings change and uncertainty. But this time can also be seen as an opportunity for behavioral healthcare providers to sharpen our focus on the approaches that will help us best move forward in addressing the population health needs of those we serve.