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Building for Value: A Foundational Structure to Support Population Health.

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  • 1University Hospitals Health System, UH Quality Care Network & UH Accountable Care Organization, Cleveland, Ohio, USA.

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Achieving value-based care requires mature population health infrastructure and systems. University Hospitals ACO outlines a three-pillar structure—operations, clinical design, and data analytics—to support this transformation.

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Area of Science:

  • Health Services Research
  • Healthcare Management
  • Population Health Management

Background:

  • Transitioning to value-based care is essential for financial sustainability and patient outcomes.
  • Healthcare organizations face risks to patient care and revenue as reimbursement models evolve.
  • Maturity in culture, infrastructure, technology, analytics, and leadership is crucial for successful value-based care adoption.

Purpose of the Study:

  • To describe the organizational structure of a clinical transformation team focused on population health.
  • To outline a functional model for managing population health within an Accountable Care Organization (ACO).

Main Methods:

  • The article details the functional organizational structure of the clinical transformation team at University Hospitals ACO.
  • It presents a three-pillar framework supporting population health initiatives: operations, clinical design, and data and analytics.

Main Results:

  • The University Hospitals ACO has developed a structured approach to population health management.
  • Key areas of focus within each of the three pillars (operations, clinical design, data/analytics) are identified.

Conclusions:

  • A robust organizational structure is fundamental for successful population health management and value-based care.
  • The described three-pillar model provides a scalable framework for health systems to mature their population health capabilities.