Accountable Care Systems and the Spectre of Health Inequity

Equity vs Equality

In August this year NHS England published a paper titled ‘ACOs and the NHS commissioning system’ In it, NHSE described its vision for commissioning set within the context of Accountable Care Systems and Accountable Care Organisations. One of the most striking features of the document was the inclusion at the very beginning of an ‘Equality and health inequalities statement’.

The debate on health inequalities has been with us for decades. Less has been written on the subject of health inequity. The distinction between inequity and inequality is nuanced but worthy of note.

If Accountable Care Systems are serious about addressing the continuing problem of health inequity then for me there are at least two stand out actions: 1. Use data to gain insight. 2. Put primary care ‘front and centre’. Read More…

Want to radically transform health services? Start by understanding your population.

population segmentation

At the recent EHI Live 2017 conference and exhibition in Birmingham an entire conference stream was dedicated to a discussion on Population Health Management (PHM). Strolling amongst the vendors in the exhibition hall it seemed everyone had a story to tell.

It would appear that PHM is a ‘movement’ whose day may have come. PHM strategies are of course closely allied to the concept and practice of Accountable Care Systems. There is a lot hanging currently on Accountable Care Systems. For many policy ‘wonks’ there is no Plan B. Read More…

Population Health Management Involves More Than Just the Data, But…

elderly community

If you are pursuing a PHM strategy it is essential that you run the numbers as a matter of routine and that your deployment of analytics — people and tools — is forensic in nature. Furthermore, you then need to acquire an intimate understanding of the meaning of those numbers. It is not the data per se that adds value, but the insights that are derived from that data. Sollis’s work in this field has to date centred on the identification of relevant populations around which PHM programmes can be targeted. This means population segmentation or the stratification of populations into sub groups that require particular services at specific intervals.
Working with our healthcare clients, which include Vanguards and Sustainability and Transformation Partnerships (STPs), we have invested a huge amount of time running the numbers. When we do so some fascinating insights emerge. Read More…

Accountable Care Systems: Betting the Farm on “Promise”?

Accountable Care Systems

Back in June this year, Simon Stevens announced the first eight Accountable Care Systems (ACS). NHS England are making some big bets on Accountable Care Systems being able to deliver on the ambitions of Sustainability and Transformation Partnerships (STPs).

Timely then that I remind myself of a conference I attended in San Diego last year where one of the speakers was Dr Linda Dunbar, Vice President, Population Health at The Johns Hopkins Community Partnership (J-CHiP). J-CHiP is an Accountable Care Organisation (ACO) offering a model of community based accountable care in Baltimore.

As far as this ACO in the US is concerned, there is no ‘silver bullet’, just a lot of hard work and a lot of focus on shifting the culture. Read More…

Identifying needs, building interventions and busting myths: adventures in population health

Identifying needs, building interventions and busting myths: adventures in population health

At the recent Health Plus Care Show at London Excel I spoke in the Transforming Primary Care Theatre. The insights I shared were harvested from a number of engagements that Sollis has had with Clinical Commissioning Groups (CCGs) over a five year period commencing in 2012. More recently this work has concerned itself with population health analytics, where we have worked with local commissioners, including clinicians, in order to help them gain a better understanding of the current and future health status/needs of their local populations. Read More…

How do we best serve the patients and populations with greatest need?

population segmentation pie chart

The challenges faced by the NHS today are in many ways those faced by health care systems across the world. The concern is a very human one; how best to serve the patients and populations with greatest need?
The starting point for those charged with service transformation has to be the need to understand who these patients are and how they currently use the health care system. There is a desperate need for insight that explains how healthcare resources are delivered and consumed. Only then can local health and care systems begin to adapt and transform in order to meet patient and population needs. Read More…

Primary Care: Home or Haven?

Primary Care Home or Haven

Primary care transformation has rightly been the focus of attention in many — if not all — of the Sustainability and Transformation Plans (STPs). It is also writ large in Next steps on the NHS Five Year Forward View. Wherever you look, primary care providers are on the march. Read More…