Population Health Management

Building an Effective Internal Population Health Operations Team

Situation

Previously having outsourced its operational efforts, one of the nations largest health systems decided to build a population health management operations team in-house to better serve its physicians, staff, and, ultimately, patients. As a significant operational change, the health system leadership team sought to bring on a partner that could assist with the transition to ensure success.

The health system turned to KSM Consulting to serve as its partner to help it create the operational infrastructure, support, guidance, and tools needed to better serve its patients and perform optimally in value-based contracts.

Engagement Activities Included

  • Development of Population Health Operations Playbook, Workflows, Policies, and Procedures
  • Operational Capacity Analysis for Implementation Purposes
Population Health

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About The Client

One of the nation’s largest health systems, which provides patients access to leading-edge medicine and treatment options, sought to build a population health management operations team in-house to better serve its physicians, staff, and patients.

Solution

The first step in the transition was to fully understand the need behind building operational capabilities in-house. The KSM Consulting team, after working alongside key resources from the health system, learned that the client wanted to ensure its internal team was well trained, engaged in face-to-face interaction with providers, and were fully equipped with the support and tools they needed at the physician and practice levels.

Understanding the need, the KSM Consulting team developed a strategy that encompassed hiring, onboarding, and training resources to equip them with the necessary tools to better serve physicians and their practices.

Key Focus Areas

  • Physician Engagement
  • Utilization Management
  • Embedded Care Management
  • Risk Adjustment
  • Practice Transformation

KSM Consulting aided the health system’s internal team in vetting the resources to guarantee the right team members were hired. Once onboard, the KSM Consulting team worked alongside the new resources to train and prepare them for the job ahead, focusing on key areas such as physician engagement, utilization management, embedded care management development and deployment, risk adjustment, and practice transformation.

As part of the training, the KSM Consulting team developed a population health operations playbook, workflows, policies and procedures, and performed an operational capacity analysis for implementation purposes. The goal of the playbook was to equip the new team with the right tools to drive success with physicians, staff, and patients. The playbook focused on four main operational areas:

  • Utilization Strategies,
  • Risk Adjustment,
  • Annual Care Strategies, and
  • Provider Engagement and Communication.

Impact

Today, the health system has the resources it needs to serve physicians, staff, and their patients better. Through in-depth training, the new internal operations team is confident in its ability to engage with physicians, is equipped to share the appropriate and critical data with both physicians and their staff to make better-informed decisions and is ultimately able to better execute on its mission of coordinated, high-quality and low-cost care.