Stephen Rosenthal Explains the Future of Health Population Strategies

Stephen Rosenthal, chief operating officer of The Care Management Company at Montefiore Medical Center, said that population health strategies are the future of the health system, where networks would be responsible for the total costs of care for the population they service.

Transcript (slightly modified)

How is the pace of payment reform moving? What are your causes for optimism and concern?

Well, I think right now there is so much pressure nationally, or at the government level, around reducing expenses and costs that I see the barriers to payment potentially becoming more problematic as opposed to less problematic. Things like the 2 midnight rule, and other kinds of quality indicators that are penalizing hospitals and taking money away instead of providing resources to help them actually improve the quality and create the resource that’s needed to actually change the program.

So, if you penalize somebody by taking some of the money away and you ask them to earn it back, they have to be financially successful enough to have enough resources to actually create the programs to earn those dollars back. So I’m concerned that the fee-for-service environment that’s currently modeled out there, these barriers will continue because I think there’s an imperative around lowering costs.

I think moving more towards a population health strategy, like the Affordable Care Act, moving more towards a global payment where a network becomes responsible for the total cost of care for the population that they service, similar to the Medicare Shared Savings Programs, the Pioneer program and now the Next Gen ACO, those are the models that I think are our future because if you’re managing a population and you know that your financial benefits are going to be based on how well you manage that population, putting barriers in to create savings is unnecessary because the savings will be created either by your success or failure in managing that population.

So put the elements back on the delivery system to do the right thing for the population that they’re servicing. So it think there’s a future in population health. I’m very concerned about the traditional fee-for-service payments becoming more and more challenging.