The 2016 SixTeenTh PoPulaTion healTh Colloquium: Summary of ProceedingSRachel S. Permuth, PhD, mSPh, Senior Director of Research, hospitals, north america & Principal epidemiologist

Jennifer m. Petrelli, Sm, mPh, nutritional epidemiologist

PoPulation

HealtH in tHe

affordable

Care aCt

institute for

HealtHCare

imProvements

triPle aim

expanded ins

urance Coverage

improved Qua

lity of Care

enhanced Pre

vention and Hea

lth Promotion

Community an

d Population-ba

sed activities

improving Pop

ulation Health

improving the

experience of C

are

reducing the

Per Capita Heal

thcare Cost

SodexowashonoredtobeaSilverGrantorandpresenteratthe2016 sixteenth Population Health Colloquium,theleadingforumoninnovationsinpopulationhealth.TheColloquium,hostedbytheJeffersonCollegeofPopulationHealth,broughthundredstogethertolearnandengageinpersonand

onlinefromMarch7-9inPhiladelphia,Pennsylvania.TheColloquiumprovidedinformationandupdates

onhealthpolicy,healthcaretrends,andpracticeandinnovation.Realworldexamplesofpopulation

healthmanagement(PHM)initiativesthatareimprovingcareandoutcomeswerealsofeatured.

ThecontentpresentedattheColloquiumprovidedavarietyofperspectivesonthecurrentand

futurestateofpopulationhealth.KeynotespeakersincludedDavidB.Nash,MD,MBA,FACP,Dean

oftheJeffersonCollegeofPopulationHealthatThomasJeffersonUniversityandChairofthe

PopulationHealthColloquium;andJulieGerberding,MD,MPH,ExecutiveVicePresident,Strategic

Communications,GlobalPublicPolicy,andPopulationHealth,Merck;FormerDirectorU.S.Centersfor

DiseaseControlandPrevention(CDC).

Conferencehighlightsincludedsessionsonengagingstakeholdersinpopulationhealth,viewing

populationhealthasaservice,effectivelyusingtechnologyanddataanalytics,engagingand

empoweringcommunities,andinnovativepopulationhealthprograms.Theoverarchingthemethat

emergedfromtheColloquiumisthatalthoughthefocusintodayshealthcareenvironmentisalready

onimprovingpopulationhealthandachievingbetteroutcomesforpatients,integrateddeliverysystems

andlargemedicalgroupsarehavingdifficultyadaptingtotheincreasingemphasisonPHM.Inorderto

pursuetheInstituteforHealthcareImprovementsTripleAimandgoalssetforthintheAffordableCare

Actof2013(seeFigure1),collaborativeintegratedcareisessential.

Centraltomanysessionsoftheconferencewasthefollowingquestion:

Given the (ambitious) goal of population health, how can we create feasible solutions to deliver better care and improve outcomes while simultaneously curbing costs?

Figure 1. Population Health in the aCa and the iHis triple aim

2 The 2016 Sixteenth Population Health Colloquium Proprietary and Confidential

Loners Worriers

Self-Centrics Attention- Seekers

FEAR OF THE INSTITUTION

DEFLECT FEAR

INN

ER F

OC

US R

EAC

H O

UT

TACKLE FEAR

Vitality

Recognition

Conviviality

Security

Listen to me Bond with me Singularize my stay

Respect my loneliness

Follow my plan Regain my balance

FromtheinformationpresentedattheColloquium,wehaveidentifiedfourkeyareasthatwillhave

importantramificationsashealthcareorganizationsseektoimplementpopulationhealthstrategies:

1. understanding and alleviating Patient fear is Key to Patient experience

2. the Case for a new Population Health Protection agenda as a means to drive down Healthcare Costs

3. using data and technology to improve Healthcare for older adults

4. engage Consumers in Wellness-based Population Health and thrive financially

understanding and alleviating Patient fear is Key to Patient experience

Inhealthcare,medicaladvancesalonecannotguaranteebetterpatientoutcomes.Helpingpatients

healorovercomeillnessinvolvesmorethanjusttreatmentthroughmedicalproceduresandproducts;

patientsmentalwell-beingandpeace-of-mindcanbejustasimportant.Dr.RachelS.Permuth,Senior

DirectorofResearch,Hospitals,NorthAmerica&PrincipalEpidemiologist,andLisaHerms,Research

Manager,HealthcareofSodexo,presentedonthephenomenonofpatientfear.Thediscussionaround

thistopicgarneredgreatinterestfromtheaudienceandstartedalivelyquestionandanswersession,

withvariousaudiencememberssharingtheirownexperiencesandperspectivesonpatientfear.

in fact, understanding and alleviating fear is central to improving the Patient experience.Ashumans,wehavecoreneeds,andfearoccurswhenoneoftheseneedsisnotbeingmet.However,fear

inthehospitalsettingisamplifiedandmuchmorecomplex.Toppatientfearsincludeinfectionand

germs,incompetence,anddeath.Thisfeartypicallyrevolvesaroundtwoaspects:alossofcontroland

depersonalization.

Thoughtheunderlyingemotionmaybeuniversal,however,everypatientexperiencesfeardifferently

(seeFigure2).Itisthereforevitalforhealthcareorganizationstolooktowardenhancingpatient

experienceinthehospitalsettingthroughinitiativestargetedatthesedifferentmanifestationsoffear.

Staffawareness,patientinvolvement,andsocialsupportareessentialforovercomingpatientfearand

arekeyareasforimprovement.

Figure 2. sodexos Personixtm visualization of different manifestations of Patient fear

Proprietary and Confidential The 2016 Sixteenth Population Health Colloquium 3

the Case for a new Population Health Protection agenda as a means to drive down Healthcare Costs

Dr.JulieGerberding,EVP,Merck&Co.,Inc.andFormerDirector,U.S.CentersforDiseaseControl

andPrevention(CDC),outlinedherthoughtsonthepopulationhealthlandscape.Shefocusedonthe

followingkeyissues:

Potential causes of the health disadvantage experienced in america relative to other high-income countries.

opportunities and limits of the affordable Care act in closing the health gap.

motivating private sector leadership actions that will help improve population health in worksites and communities, and inform local, state and national policies.

TheU.S.hasrelativelyunfavorablehealthoutcomescomparedtootherhigh-incomecountries,despite

ourvastexpenditureonhealthcare.TheOrganizationforEconomicCooperationandDevelopment

rankedtheU.S.NationalHealthPerformanceamong34countries,andtheU.S.ranked26thinlife

expectancy,31stininfantmortality,28thinlowbirthweight,and25thinmaternalmortality.

WhydoestheU.S.experiencethishealthdisadvantage?Thereareavarietyofissuesthatare

hypothesizedtocontributetotheproblem.Oneissueisthatourhealthcaresystemisinefficientand

encouragesunnecessary,redundant,andexpensivecare.Therearealsopublichealthsystemissues.

Forexample,ourpublichealthsystemisnotadequatelylinkedtothehealthcaredeliverysystemand

notadequatelyresourcedtoaccomplishitsmission.In2014,only3%ofthenationshealthdollarswent

towardspublichealth.OtherfactorscontributingtothehealthdisadvantageareshowninFigure3.

Figure 3. determinants of the u.s. Health disadvantage

Healthcare & Public Health System

Issues

sHorter life

exPeCtanCy & Poorer HealtH status

Policies & Culture

Economic & Psychosocial

Factors

Physical & Social

Environment

Individual Health

Behaviors

u.s.

HealtH

disa

dvan

taGe

4 The 2016 Sixteenth Population Health Colloquium Proprietary and Confidential

Dr.Gerberdingemphasizedthatthe most powerful opportunity for stopping the growth in the cost of healthcare in the united states is to create more health in the population.ShefurtherdiscussedtheideathathealthimprovementisnotonlybroughtaboutinthedoctorsofficeortheACO.Healthy

behaviorsarefosteredinourhomes,schools,worksitesandcommunities.Theproblemisthatweare

notinvestinginprogramsandservicesthatimprovehealthandwell-beingfromabroaderperspective.

Creatingaholistichealthsystemthatpromotesbetterhealthandgreaterhealthequalityisimperative.

AccordingtoDr.Gerberding,privatesectorleaders,especiallythoseinthehealthsector,haveaunique

opportunityandresponsibilitytocatalyzeprogresstowardbetterpopulationhealth.Shecalledupon

privatesectorleaderstosetthetoneatthetop,byprovidingsmokingcessationbenefitsforemployees,

nudgingemployeestochoosehealthierfoodchoicesandengageinphysicalactivityandincentivizing

wellnessinthedesignofbenefitsprograms.

Shealsoencouragedprivatesectorleaderstofosteralliancesincommunityhealthnetworksby

engagingwithpublichealthleaders,committingleadershipandresourcestosupportingpriority

communityeffortsandputtinghealthonthebusinessagenda.

Proprietary and Confidential The 2016 Sixteenth Population Health Colloquium 5

using data and technology to improve Healthcare for older adults

Dr.JaewonRyu,MD,SegmentVicePresidentandPresidentofIntegratedCareDelivery,Humana,Inc.,

spokeaboutseniorsbeingthefocusofpopulationhealthforHumana.Heemphasizedthatcreatingthe

rightenvironmentmakesitpossibletoexpectimprovedhealthforolderadults.

Humanaisworkingtoaddressmultiplefactorstiedtothehealthofolderadults,including:

Casting a broader net from the traditional scope of the healthcare system to encompass non-traditional areas that impact health.Thisincludesaccesstonutritiousfood,chroniccarecoordination,real-timemonitoringofolderadultsandtheuseoftechnology(smartphones/tablets).

moving from traditional to integrated healthcare. Inthetraditionalhealthcaremodelpatientsoftenexperiencedis-integrated,episodicandconflictedcare.Intheintegratedhealthcare-model,careis

patient-focused,primarycare-centricandproactive.

Preparing care providers for the new era of population health.Physiciansneedassistanceintransitioningfromthevolume-basedtovalue-basedmodelofcare.Therearesignificantgapsinthe

transitiontowardvalue-basedcare,andmanyorganizationsarenotreadytomeetthechallenge.

using data, analytics and technology to bring about results.Theuseofanalyticsallowsforactionableinsightsthatdrivevalue.Telehealthisalsogainingprominence,includingremote

monitoringasawaytoextendcaremanagementand/ortelemedicine/eVisits.Forexample,Dr.Ryu

notedthattele-dermatologyimprovespatientaccesstocareandreduceswaittimesfrom21daysfor

anappointmentto42minutesforapatienttoreceiveacareplan.

Dataandtechnologyarepowerfultoolsintheintegratedhealthcaremodel.Theycanbring

interventionstoalargernumberofpeopleandimproveaccesstocare.High-costandhigh-risk

individualscanbetargetedandresourcescanbeappropriatelydeployedtogetpatientsthecare

theyneed,whentheyneedit.Itiscriticalthatcareprovidersreceiveassistanceinadaptingtonew

innovationsandotherdemandsoftodaysintegrated,value-basedsystemofcare.

6 The 2016 Sixteenth Population Health Colloquium Proprietary and Confidential

engage Consumers in Wellness-based Population Health and thrive financially

Dr.DavidJ.Peter,ChiefMedicalOfficerandLauraKukral,DirectorofStrategyoftheClevelandClinic

AkronGeneralMedicalCenter,Akron,Ohio,discussedhowAkronGeneralahighlyrenownedand

influentialOhiohospitalviewspopulationhealth.Dr.PeteremphasizedthatPopulation health is a mode you take your organization into. it is a philosophy.

KeycommunityhealthprioritiesforAkronGeneralincludechronicdiseases,mentalhealth,accesstocare,

substanceabuse,smokingcessation,elderlycaresupportandobesity.Theseareconcernsthatarefamiliar

tohealthprofessionalsinvolvedinCommunityHealthNeedsAssessmentsinhospitalsacrosstheU.S.

AkronGeneralhasmadewellness-basedpopulationhealthcentraltoitsmissionfor20years.Theyhave

institutedthreehealthandwellnesscenters,whichincludegyms.Infact,35%ofgymmembersbecome

first-timeusersoftheClevelandClinicAkronGeneralHealthSystemafterjoining.Throughthesecenters,

Akronisabletotakeitscareastepfurtheranddeliverhigh-valuecareacrossthebroadercontinuum.

akron General medical Centers emphasis on the community is part of its success, and has moved it from the red into the black.

Proprietary and Confidential The 2016 Sixteenth Population Health Colloquium 7

ThekeycomponentsofAkronGeneralsapproachincludecommunityhealthimprovementand

repositioningitsbrandarounditswellnessmessage.Throughafocusoninnovationinseveralkeyareas

(seeFigure4),Akronhasbeenabletoachieveitspopulationhealthgoalswhilealsothrivingfinancially.

Figure 4. akron General medical Centers Key areas of focus for Population Health improvement

AquotefromAkronGeneralsCEO,Dr.TimStover,aptlysumsuptheunderlyingfoundationofAkrons

presentation.HestatedthatWe want to put smart minds around us who can help discover what clinical prevention should really look like; and can define medical fitness best practices for the next 20 years.NotonlyhasthisbeenasuccessfulprincipleforAkron,butitcanalsoserveasaguidelineforotherhealthcareorganizationsastheyseekinitiativestoachievethesamegoalofpopulationhealth.

outreaCH

researCH Collaboratives

innovative delivery

Consumer enGaGement

Partnerships to improve health of low SES groups

Mobile unit offering services (e.g., physicals, health screenings, womens health exams, educational classes)

Kent State University

Cleveland Clinic Wellness Institute

Health & Wellness Center

LifeStyles

8 The 2016 Sixteenth Population Health Colloquium Proprietary and Confidential

Conclusion

The2016PopulationHealthColloquiumfocusedonseveralareaspertainingtothefutureofpopulation

healthintheeraofvalue-basedcare.AccordingtoDr.DavidB.Nash,theDeanoftheJefferson

CollegeofPopulationHealth,thedefinitionofpopulationhealthisstillnebulous.Yet,populationhealth

managementisattheforefrontofthehealthcareagenda,andthegoalofPHMisclear:todeliverhigher

qualitycareandachieveimprovedhealthoutcomesforpopulations.

Hospitalsandotherprovidersarenowincreasinglypaidbasedonthequalityandeffectivenessof

theircare,ratherthanthesheervolumeoftestsandotherprocedurestheyperform.Therefore,itis

necessarytonotonlyaddressacutemedicalneeds,butalsotheemotionalandsocialwell-beingof

patientsandthekeysocialdeterminantsofhealthofacommunity.Morespecifically,providerswillhave

toaddressfactorsthatnegativelyimpactthePatient Experience,suchaspatientfear,andimproveinvolvementwithcommunityentitiesinordertosucceed.

Toaccomplishtheambitiousaimsofthepopulationhealthagenda,collaborativeintegratedcareis

required.ThemostpowerfulopportunityforstoppingthegrowthofhealthcarecostsintheU.S.is

tofosterimprovedhealthinthepopulation.Theprivatesectorshouldstrivetofindsharedvaluein

populationhealthopportunitiessuchasdiabetespreventionandpopulationvaccinecoveragewithin

thecommunity.Dataanalyticsandtechnologycanalsobringmeaningfulinterventionsandimprove

accesstocare.Butphysiciansandhealthsystemsneedassistanceinmeetingthechallengesposedby

thenewpopulationhealthfocus.

Insum,theColloquiumallowedforfrankdiscussionsaboutthecurrentstateofpopulationhealth

andthechallengesposedbytheAffordableCareAct.However,speakersandaudiencemembers

acknowledgedthatmanyquestionsremainunanswered.ForumslikethePopulationHealthColloquium

arecriticalforexchangingideasandfocusingonviablesolutionstoaccomplishournationspopulation

healthobjectives.

additional resources

TolearnmoreaboutthePopulationHealthColloquium,populationhealthandSodexoscontributionsto

populationhealthinitiatives,thefollowingresourcesmaybeofinterest:

Population Health Colloquium website: www.populationhealthcolloquium.com

sodexo White Papers:

SodexosPopulationHealthManagement:Approach&KeyRoleofRegisteredDietitianNutritionistshttp://viewer.zmags.com/publication/cd16a7af#/cd16a7af/1

UnderstandingandManagingPatientFearintheHospitalSettinghttp://viewer.zmags.com/publication/0351c0e8#/0351c0e8/1

NewChallengesFacingtheHospitalC-Suite http://viewer.zmags.com/publication/1e16c929#/1e16c929/1

CommunitiesforHealthLaunchEventSummaryofProceedingshttp://viewer.zmags.com/publication/dc43c72e#/dc43c72e/1

GoingBeyondtheFourWalls:PopulationHealthManagement(PHM)PartnershipStrategiesMUSC&Sodexohttp://viewer.zmags.com/publication/c8359abd#/c8359abd/1

AmbulatoryNetworks:ThePowerofTechnologyhttp://viewer.zmags.com/publication/082d4227#/082d4227/2

additional white papers can be found on sodexos thought leadership library: bit.ly/sodexothoughtleadership

Proprietary and Confidential The 2016 Sixteenth Population Health Colloquium 9

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