Rewriting the Rules of Value-Based Care

At Populance, we are driven to pursue a new era of health.

One that’s people-centered, affordable, and sets a new standard for the right care—delivered at the right place at the right time. Which, when you think about it, is how care should be.

Intentional. Proactive. Equitable. Care should be accessible and affordable. It should provide an exceptional experience at every level. It should improve health in and across communities and make people feel better about the journey to feeling better.

The need is great

Right now, the health needs of patients and populations are changing rapidly. Healthcare is expensive, making up nearly 20% of the U.S. gross domestic product (GDP). Life expectancy is trending down, and people face challenges with access to care and health disparities. There’s also a rise in the number of people living with chronic conditions, and we’re experiencing a major mental health crisis. The numbers are dismal:

  • $3 out of every $4 spent on healthcare goes toward chronic disease1
  • 90% of US’s $4.5 trillion in annual health care expenditures are for people with chronic and mental health conditions 2,3
  • 5% of the population consumes almost half of all healthcare costs4
  • $52.4 billion: cost for patients readmitted within 30 days5
Does This Sound Familiar?
“I’m handcuffed by the system … I wish I could see real improvement in my patients … The same person just got readmitted for a third time. There must be a better way.”

Value-based care is part of the answer

Populance is reshaping and elevating the healthcare experience—while lowering costs. Through our value-based care services, we focus on five interconnected areas:

  • Outcomes: Enhance health outcomes for individuals and the community
  • Patient experience: Improve quality of care with a personalized approach
  • Provider experience: Provide actionable data and integrated case management
  • Equitable access: Broaden and navigate access to healthcare services and address health equity issues
  • Cost: Generate value and decrease overall cost of care

Serving a population happens one person at a time. That doesn’t mean it should be inefficient or expensive.

At Populance, we’re focused on providing the most effective healthcare to each patient. Our diverse patient pool includes everyone from the sickest to the healthiest. With our data and engagement tools, we can personalize care to provide what each patient needs, when they need it most. For the most sick and vulnerable patients, this means managing them closely, using focused personal intervention to remove major health barriers and help improve outcomes. For healthy patients, it means giving them the resources they need to stay healthy.

We help healthcare organizations transform the health experience for the better while lowering total cost. There’s no magic wand—we’re an expert team of solvers ready to work alongside you (with some powerful data expertise) to create connectivity and efficiencies.

The Power of Smart, Simplified Analytics ...
Any barrier between you and your patients is one we want to knock down. That data you need? It’ll be right there. Immediate. Accessible. Not forty-five clicks down an informational rabbit hole.
... and Integrated, Streamlined Case and Care Management
The right care isn’t the right care when it’s delivered at the wrong time. Or at a crushing cost. So how do you optimize? By focusing on people—and taking a samurai sword to the red tape.

Populance FAQs: The nuts and bolts

  • What Are the Benefits of Value-Based Care?
    Core area Fee-for-service Value-based
    Fee-for-Service vs. Value-Based Care
    Payment structure Reimburses healthcare providers for each service or procedure performed, regardless of patient outcomes. Focuses on rewarding healthcare providers based on patient outcomes, quality of care and overall value provided.

    Incentives

    		 Physicians and hospitals are paid based on the number of sick patients treated and number of procedures performed (regardless of the outcome). Physicians and hospitals want to keep people healthy, making sure that when care is needed it’s provided with the highest quality and efficiency.
    Focus Emphasizes treating illnesses and managing symptoms. Prioritizes preventive care, wellness initiatives and disease management strategies.
    Approach to care
    		 Separate payments for each transaction of care drives a fragmented patient experience and complications.
    		 Encourages collaboration among healthcare providers and emphasizes care coordination.
    Cost Fee-for-service payments contribute to rising healthcare costs for patients and communities due to its incentive structure that prioritizes quantity over quality of care.
    		 Value-based care helps control healthcare costs in the long term by promoting preventive measures, reducing hospital readmissions and improving overall patient health outcomes.
  • What Is Populance?

    Populance is a population health services company that is affiliated with Henry Ford Health. We work with organizations such as independent physician offices, health plans and health systems to improve outcomes and experience, while reducing total cost of care through the value-based care services we offer. While we manage risk, we are not an insurance entity.

    There’s immense value in value-based care—for everyone. (And it doesn’t come from packing more patients into a doctor’s day.)

    Our data and insights help develop a sharper picture. Doctors will know when their patients need them—and the care only a doctor can provide—or when a nurse, case manager, social worker or even a digital tool can meet the need instead. Using insights from data, the patient is empowered at the right time with the right information to take the next step in their health journey.

    This means that instead of feeling overwhelmed, you’ll feel confident. Knowing that you’re prioritizing the patient who needs care the most at the exact right moment, while all patients receive excellent care.

    We are committed to leading the new era—fearlessly rewriting the rules as we go, unearthing new paths that will advance our mission and create ripple effects for the world to follow.

  • What Services Does Populance Offer?

    We essentially act like a shepherd for patients, providing guidance and care management in several ways, including:

    • Population health data analytics
    • Care management
    • Utilization effectiveness
    • Care modality (at-home, virtual and remote patient monitoring)
    • Digital engagement and interventions
    • Value-based care transformation consulting
  • How Does Populance Improve Quality of Care?

    Our value-based care services improve care in several ways:

    • Improving outcomes by measuring and tracking quality indicators, performing targeted interventions and providing preventive care
    • Improving and fostering patient engagement
    • Coordinating care and wellness
    • Coordinating care into high-performing networks
    • Working directly with patients who have the most needs to help close gaps in care (affording medications, accessing specialists, avoiding emergencies or staying at home safely after a hospitalization)
    • Saving cost through reducing hospital visits
    • Managing chronic disease through improved monitoring
  • What Distinguishes Populance’s Analytics?

    Don’t guess who needs you. Know.

    We're your partner for advanced analytics and for taking action. So you can identify who’s at risk and intervene—more rapidly and accurately than ever before. We’ve built a better analytics mousetrap, which features:

    • A source of truth: Aggregate data with a centralized data repository to deliver actionable insights, promote earlier patient intervention and facilitate patient-centered care.
    • Simplified access: When you’re trying to access data, even two or three extra steps is too many. It’s overcomplicated, frustrating and a waste of your time. We believe in ease, and we’re obsessed with making things simpler, for you and for your patients.
    • Secure: Our platform is secure, cloud-based and HIPAA compliant with access controls in place.
    • Outreach tools: Including digital and automated messaging features for enhanced outreach and engagement with patients and their caregivers.
    • Outcome reporting: Patient and member data is available through standard reports and audit trails to identify trends and manage patient quality outcomes or accreditation standards.

  • Specifically, How Can You Help With Case and Care Management?

    Populance’s value-based care services can help manage several types of cases, including:

    Ambulatory

    We focus on complex patients to reduce severity of the disease and its effects and progression—maximizing their time at home vs. being in the hospital or undergoing surgery. This includes:

    • Nurses, case managers and social workers embedded in clinical settings and virtually (we meet patients where they are)
    • Support to patients with chronic conditions
    • Helping patients safely transition to home after hospitalizations and staying away from needing emergency care

    Specialty condition management

    Our specialty condition management emphasizes early intervention and is person-guided, including:

    • Specialty clinicians (nurses/dietitians) who manage a holistic view of a patient’s specific condition, such as diabetes
    • The focus typically is on condition support as part of an ambulatory case management plan

    Supportive care management

    This type of extended management typically lasts 6-8 months, and includes:

    • Nurse-led care and coaching for advanced chronic illnesses with high risk of poor outcome over the next 1-2 years
    • Optimizes time at home and the caregiver connection, including advanced care planning and symptom management

    Transitions of care

    Our transitional care focuses on three key areas, including:

    • A safe and seamless handoff across care settings, typically from the hospital
    • Readmission reduction, including PCP follow-up, medication management and anticipatory guidance
    • Keeping patients safely at home, which may include home health, remote patient monitoring and additional home-based services
  • What Is Utilization Effectiveness?

    One key process we use to provide the most effective care while controlling the cost of care is utilization effectiveness. This means working with the clinical team to develop pathways for patients to use the most appropriate and beneficial treatments at the lowest cost—ensuring that each patient receives the care they need, at the right place and the right time, while saving cost. We do this in a few ways:

    • Using data to identify individuals or groups of patients with the greatest care needs
    • Proactively supporting patients who are at high risk or who use services such as the emergency room or hospital frequently
    • Encouraging patients to choose care in lower-cost settings, when appropriate
  • I’m a Physician. Will Populance Affect My Oversight of Patient Care?
    Not at all. You’re the person they trust. So we make sure you’re squarely in charge of your patients’ care. You direct all the resources (that means no care or services provided without your knowledge).
  • I’m a Patient. How Will Populance Affect My Healthcare Experience?

    Populance will work behind the scenes with the clinical team to ensure that your healthcare journey is streamlined. Our goal is to be a seamless part of your current healthcare team and in most cases you won’t know we’re there.

References

  1. Hamilton, G. (2018, June 19). 3 elements essential for population health management strategy. Becker’s Hospital Review. https://www.beckershospitalreview.com/care-coordination/3-elements-essential-for-population-health-management-strategy.html
  2. Buttorff C, Ruder T, Bauman M. Multiple Chronic Conditions in the United States. Rand Corp.; 2017.
  3. National health expenditure data: historical. Center for Medicare & Medicaid Services. Updated December 13, 2023. Accessed February 6, 2024. https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/historical
  4. Holle, M., Wolff, T., & Herant, M. (2021). Trends in the Concentration and Distribution of Health Care Expenditures in the US, 2001-2018. JAMA network open, 4(9), e2125179. https://doi.org/10.1001/jamanetworkopen.2021.25179
  5. Nuckols, T. K., Keeler, E., Morton, S., Anderson, L., Doyle, B. J., Pevnick, J., Booth, M., Shanman, R., Arifkhanova, A., & Shekelle, P. (2017). Economic Evaluation of Quality Improvement Interventions Designed to Prevent Hospital Readmission: A Systematic Review and Meta-analysis. JAMA internal medicine, 177(7), 975–985. https://doi.org/10.1001/jamainternmed.2017.1136
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