In mid-2015, Emily Brower was appointed to the newly-created position of Vice President of Population Health at Atrius Health. Brower faced the challenge of framing a strategic plan to integrate population health approaches more broadly across the large physician practice organization.
In healthcare services, population health management referred to developing systems of care for groups of patients based on their clinical needs to increase quality, control costs, and enhance patient experience. One of the central ideas of population health was to use medical informatics to manage the care of groups of patients who shared demographic characteristics or chronic ailments. In so doing, population health changed the focus from treating individuals to managing larger groups of patients.
Atrius Health had significant experience with population health management. The non-profit healthcare organization had formed through the affiliation of several group practices in the greater Boston area, including some with experience in incorporating health care informatics into more traditional patient management activities, as well a home health and hospice agency. Recently, Brower had helped implement a highly successful Pioneer Accountable Care Organization (ACO) within Atrius Health that oversaw the treatment of Medicare patients. Atrius Health was organized in a way that could facilitate broad implementation of new programs, as it was built on a network of large independent groups that had merged together to become a single entity. The merged organization also brought in a new CEO in 2015, Dr. Steven Strongwater, who was a strong proponent of population health management.
Brower faced numerous design decisions in creating a strategy to realize the full promise of population health within Atrius Health. How should Atrius Health most effectively define the populations to be managed? Should the services be located within the local practice offices or managed centrally? How should physicians be involved in the implementation of the programs, and what should be the role of advance practice clinicians such as nurse practitioners (NPs), physician assistants (PAs), registered nurses (RNs) and pharmacists? What was the best way to involve patients? Should the strategy seek to transform the organization quickly or should programs be rolled out incrementally?
Whatever decisions Brower made, she knew that she had to be sensitive to the interests and perspectives of numerous stakeholder groups. Improving the group practice’s ability to manage its complex, high cost patients seemed imperative. The physician-patient relationship had always been essential to the delivery of high quality health care in the diagnosis and treatment of disease. Changes, even subtle ones, could upset existing bonds and prevent buy-in, dooming programs to failure. On the other hand, employers and health plans were eager to see changes in healthcare management that could make medical services more efficient and effective.
Published Date: March 28, 2016
Suggested Citation: Greg Licholai, Aron Berke, and Jaan Elias, “Population Health Management at Atrius Health,” Yale SOM Case 16-015, March 28, 2016.
Keywords: Population Health, Group Practice, United States, Women in Leadership