Advancing the Concepts of Population Health and Consumerism

The next generation of healthcare was the main topic of conversation at the 65th Annual Roy A. Bowers Pharmaceutical Conference, held by the Ernest Mario School of Pharmacy at Rutgers, The State University of New Jersey.

The morning sessions were filled with discussions on population health and consumerism. While consumerism is by no means a new concept, it is accelerating, said Alfraid F. Tallia, MD, MPH, professor and chair of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School and executive director of Robert Wood Johnson Partners, RWJ University Hospital and Rutgers, The State University of NJ.

“The big issue that is driving this is the fact that individuals are having to assume greater and greater responsibility for cost,” he said. However, he pointed out the trouble is that expenditures are not evenly distributed and he cited a Deloitte study from 2012 that identified 6 types of consumers:

• Casual and cautious—34%; these consumers have no immediate health needs
• Content and compliant—22%; they are happy with their doctors, hospitals, and insurance
• Online and onboard—17%; they are interested in learning online and seeking new technologies
• Sick and savvy—14%; these are high consumers and are partners with their physicians
• Out and about—9%; these consumers seek alternative options and customized services, such as concierge medicine
• Shop and save—4%; they are looking to save money and will switch care for better value

Dr Tallia admitted that he suspected the results would look a little different if the study was done today, specifically because he suspects the last group has grown a lot more.

“How we organize our services and tailor our services need to take into consideration some of these consumer types,” he said. “Which begs the question: what do people want from the healthcare system?”

Minalkumar Patel, MD, MPH, senior vice president and chief strategy officer at Horizon Blue Cross Blue Shield of NJ, also touched upon the fact that consumerism is not new particularly since consumers have always purchased healthcare.

However, what has changed is that now there is a higher level of intensity in the consumer’s ability to make decisions about his or her own care. This plus the increased cost implications, means there is a higher level of engagement required in healthcare.

Population health is also undergoing a change, mostly because many organizations simply cannot agree on a definition of population health, explained Kimberly E. White, MBA, senior consultant for Numerof & Associates, Inc, which recently surveyed C-suite executives across the country to determine the status of population health in the country. The company found that there are a lot of disparate ideas of what population health is and where organizations are in moving to population health.

On the one end of the spectrum there are organizations that think of population health as community health, as health for the sake of the community without tying it to specific outcomes. On the other end, there are organizations that realize population health is an entirely different business model and way of thinking that shifts from being in the business of sickness to health and wellness.

The survey results also showed that one of the reasons organizations are moving to population health is because they are coming to realize it is more in line with their missions than some of the work they had already been doing.

In addition, they found that many organizations are waiting to be told to take action in moving to population health. This is going to be a problem, White believed, because the transition requires a cultural change among the organization.

“It’s going to take time and it’s not something as easy as saying ‘We’re moving to population health tomorrow,’” she said.