Population Health Management Can Save You Big Money


Marion McGowan, Ph.D. is the chief clinical officer and senior vice president of population health for the UPMC Insurance Services Division, which includes UPMC Health Plan, WorkPartners, LifeSolutions, UPMC for Life, UPMC for You, UPMC for Kids, Askesis, and Community Care Behavioral Health.

The Integrated Benefits Institute recently reported that poor health costs the U.S. economy nearly $600 billion per year, with a significant chunk of that cost coming from lost productivity.

But there are ways employers are fighting back. One is by incorporating population health management into your benefits package. Population health management is an increasingly popular and powerful tool that helps employers to rein in employee healthcare costs.

For the latest on how population health management can help you lower healthcare costs and raise employee productivity, we spoke with Marion McGowan at UPMC Insurance Services Division.

What exactly is population health management (PHM)?
Population health refers to the specific illnesses or health problems that exist within a targeted group of individuals, such as the employees of a particular company. Managing population health involves developing interventions and incentives and other strategies that lead to better individual health. Interestingly, the trend
toward managing the health of employees represents a sea change among employers. In today’s workplace, making use of PHM extends the responsibility and interests of the employer beyond just providing salary and benefits.

Why is population health management important to employers?
Many employers see improving workforce health as a key to long-term cost management. Healthy employees translate into more productive employees. And with the right PHM program in place, employers often see more engaged employees that enjoy increased levels of job satisfaction. The goal is to try to prevent those who are well from becoming ill and improving the quality of life and enhancing health outcomes for those who have developed one or more chronic conditions.

Should employers ask their health insurance company about population health management?
Employers absolutely should ask their insurance carriers about PHM. Employers need to know the value they are getting and that they’re getting the right care for their employees. The chief cost drivers in any health insurance plan are your sickest employees. But a good PHM strategy can help anticipate the needs of the employees who use the most health care. It can also tailor interventions to help curtail unplanned and costly care and help employees with chronic conditions get the preventive care they need before it becomes more expensive for everyone.

In terms of overall employer costs, is it worth it to invest in a population health management program? What’s the ROI?
There is growing evidence that the investment is worth it. The ROI for a population health management program ranges from $1.40 to as much as $13 in benefits per dollar spent on the program.

Does a population health management program make sense for smaller companies?
Because of the investment dollars that large employers have at their disposal, they are most involved in PHM programs. But it’s arguably even more important for small companies to invest in PHM as part of their benefit design.
In a small company with only a few employees, one person with a chronic disease can skew the cost curve and risk pool dramatically and as we know, healthy employees tend to be present more at work, which increases overall productivity. Whether it’s a large corporation or small family-run business, every employer has the opportunity to positively affect the health of their employees.

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