Applying the Medical-Legal Partnership Approach to Population Health, Pain Points, and Payment Reform

Description

In an effort to control health care costs, many healthcare delivery organizations have agreed to contracts that incentivize the provision of high-quality care and penalize unnecessary or preventable healthcare utilization. This is consistent with the Affordable Care Act’s emphasis on improving health care quality and the introduction of quality standards. Healthcare providers thus must adapt how they practice in response to this payment reform, often without the tools to understand how to meet quality standards and reduce their costs or utilization patterns. Population health management has emerged as a solution to the “pain points” — missed quality metrics or incentives that affect the amount a healthcare institution is paid — associated with payment reform. Population health management assesses the health outcomes that exist within a defined population and asks what medical, social, and civil legal needs are affecting those outcomes. By identifying risks within the population and seeking to intervene before those risks become costly medical crises, health care providers can maintain or even improve the health of their patients while also reaping financial rewards for the healthcare delivery organization.

This issue brief from the National Center for Medical-Legal Partnership examines two examples of payment reform pain points felt by healthcare institutions adapting to new reimbursement models, and the treatment of those pain points through collaboration with medical-legal partnerships (MLPs). This is followed by recommendations on how an MLP can become part of those population health management teams that are revolutionizing health care one population at a time, and the advantages of doing so, both for the health care institution and for the sustainability of the MLP approach.

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Author

• Joanna Theiss, Research Assistant, National Center for Medical-Legal Partnership

• Megan Sandel, Medical Director, National Center for Medical-Legal Partnership

• Joel Teitelbaum, Co-Principal Investigator, National Center for Medical-Legal Partnership

• Kate Marple, Director of Communications, National Center for Medical-Legal Partnership

This issue brief was published by the National Center for Medical-Legal Partnership.

Acknowledgment

This brief is possible with support from the Robert Wood Johnson Foundation, The Kresge Foundation, and the Public Welfare Foundation.