The fee-for-service healthcare system has created an environment in which even the most basic care can be either ignored or delayed. This happens for a variety of reasons, whether it be due to cost, inconvenience, or simple conditioning to not access the healthcare system until there is a catastrophic issue to address.
From a population health perspective, this approach can be devastating. Any effective population health management approach relies on providing effective and appropriate care to all segments of a population.
We call the segment of the population that actively delays and defers care the apparently healthy. They make up the vast majority of any population (75%) while costing the least to care for (20% of the costs for a whole population).
In this post, we’ll explain why effectively engaging with this population is the key to driving long-term cost savings for a population and how the apree health advanced primary care (APC) model does just that. But first, let’s briefly review how we segment a typical member population.
The makeup of a typical member population
Every population is broken up into three segments:
With these common definitions, let’s turn our focus back to the apparently healthy.
Why apparently healthy members are the key to cost control
Apparently healthy members are just that: apparently healthy. The very reason they are the most cost-efficient portion of the population is also why they are the key to cost control. Because they typically exhibit no outward signs of major health issues, they tend to skip preventive care.
When an apparently healthy member skips a screening or an annual physical, they’re missing a chance to catch a major health issue early that, if left unnoticed, could move them into the polychronic segment, significantly impacting their health and driving up their overall cost of care.
Keeping as many people as possible from moving to the polychronic segment is the best way to keep the total cost of care down.
This is why actively providing care for the apparently healthy segment and quickly identifying those who are at-risk will have the greatest impact on the total cost of care.
How apree health APC effectively cares for the apparently healthy
The apree health APC model ensures that the apparently healthy population receives appropriate care through five specific tactics. This type of engagement leads to early diagnosis of any potential issues, reducing the long-term total cost of care for the population. Let’s take a look at each one:
This five-part approach allows apree health’s providers and care teams to identify potential health issues in apparently healthy members far before they become major concerns. As a result, some can be addressed by lifestyle changes, others by some type of medical intervention. The bottom line is that none of these issues will be left unnoticed until they become catastrophic and the member finds themselves in the polychronic segment.
Controlling total cost of care is all about more intentionally caring for the population segment that is apparently healthy so they never progress to more costly segments.
The apree health APC model is ideally built to do just that.