Ninety-three percent of healthcare providers believe population health will have a significant impact on their organization within the next two years, according to a recent HIMSS Analytics Survey, sponsored by Intel[1]. Providers are preparing for that impact by planning for, and implementing, various initiatives focused on population health.

The implementation of new initiatives often brings challenges. Respondents to the HIMSS Analytics survey identified three primary challenges for organizations seeking to prepare for population health impacts. The three top challenges identified are budget or financial challenges, a lack of necessary infrastructure, and a lack of strategic direction/vision centered on population health.

Budget concerns are both a driver, and a challenge

One-third (33 percent) of respondents ranked budget or financial concerns as their No. 1 population health challenges. Seventy-nine percent ranked budget or financial concerns among their top three challenges. "We are struggling financially," said the CIO of one intermediate-size (101 to 250 bed) provider.

Budget concerns around population health focused on two separate issues. For some providers, their budget concerns relate to being able to allocate enough institutional budget to infrastructure supports (technology, expertise) needed to effectively implement population health initiatives across the organization. The senior IT analyst at an intermediate-size provider (251 to 500 beds) said: “I think there are always budgeting issues. It's hard when you're trying something new because obviously the powers that be want to see that return on investment.”

On the other hand, some providers see population health initiatives as imperative because of concerns about how population health trends may impact patient mix, payer mix and hospital revenue. As healthcare moves away from fee-for-service, and toward value-based care, the proportion of “at-risk” patients will increase. (For the purposes of the survey, ‘“at-risk”’ patients were defined as patients falling within value-based care initiatives, such as Medicare and Medicaid patient populations.)

This makes it even more important for providers to effectively manage patient populations. To that end, many population health initiatives are beginning to focus on prevention, as much as on treatment. The director of information services at a large (500-plus bed) provider said: “We need to make sure that those who are healthy, stay healthy. We need to figure out what the key interventions are to make sure that happens.”

Infrastructure not yet in place

Just under one of five (17 percent) ranked ‘“lack of necessary infrastructure”’ as their No. 1 population health challenge. However, 63 percent ranked lack of necessary infrastructure among their top three challenges. “We don’t have one integrated tool set to meet our [population health] needs,” said the CIO of an intermediate-size (101 to 250 bed) provider.

The director of information services at a large (500-plus) bed provider said, “We don’t have a dedicated [population health] platform right now, although we very much need one.” In response to technological infrastructure challenges, 41 percent of providers plan to “do what we can with the systems we have in place.” More than one-third (35 percent) plan to invest in technology that specifically supports population health initiatives. Twenty-seven percent plan to “reinvest in scalable infrastructure”, and 21 percent are uncertain as to how they will deal with technology infrastructure challenges.

Providers struggle with strategic vision

Seventeen percent ranked “lack of strategic direction/vision” as their No. 1 population health challenge. Forty-four percent named a lack of strategic direction/vision as among their top three population health challenges. The CIO of an intermediate-size (101 to 250 bed) provider said: “We don’t really have an official population health management task group. Everybody’s kind of working on little bits and pieces, but we don’t have a concentrated effort. I think that’s our biggest weakness.” The CEO of a small (fewer than 50 bed) hospital said: “I think our organization has the desire to get there. We are building a vision for everybody to be part of. Part of our leadership [goal] for this next year is to lay out that [population health] vision for folks to see the big picture.”

Given these challenges, providers struggle to state with certainty that they are prepared for the impact that population health trends will have on their organizations. “We hope we’re preparing, but the future is so uncertain,” said a physician at a small (fewer than 50 bed) hospital. “I don’t think most organizations know if they will safely navigate these treacherous waters that are coming. ... I’ve been in medicine 35 years, and I’ve never felt so unsure about where we’re headed and what’s going to happen next.”

Access more information from this sponsor here: Investing in Population Health Initiatives.