Financial Improvement: Targeting at ICB level through Population Health Management

Introduction

So far, Akeso’s Financial Improvement series has outlined the opportunities for realising tangible efficiencies and savings over short, medium, and long-term timeframes, with examples of our proven experience working with NHS organisations, collaboratives and systems.

In this article, we will take a closer look at the opportunities for Integrated Care Boards to leverage Population Health Management to support long term improvements in health outcomes and associated efficiencies.

Context

The prevalence of chronic health conditions in the UK continues to rise, and with this so does the burden on healthcare services. For example, more than 4.9 million people live with diabetes, with 13.6 million at risk of developing type 2 diabetes[1]. Obesity is another significant public health challenge. It is estimated 36% of adults within the UK will be obese by 2040[2], a key risk factor for type 2 diabetes, as well as cardiovascular disease, cancer, and musculoskeletal disorders, amongst others.

These chronic conditions not only impact quality of life at population level but also come with significant financial and economic implications – last year, NHS spend on diabetic care accounted for circa 10% of the total budget[3], with the annual cost of obesity to the UK economy estimated at £58 billion. Quality of Life Years (QALYs) measures the loss of productivity and quality of life costs for individuals at £39.8 billion, and costs for society as a whole at £7.5 billion, demonstrating that addressing health risks can add far more benefits than just cost reductions to the NHS[4].

Integrate Care Boards and Population Health Management

Population Health Management (PHM) is a methodology that uses data-driven planning and delivery of proactive care via risk stratification and population segmentation to improve physical and mental health, promote wellbeing and reduce health inequalities across a population, with a specific focus on the wider determinants of health (e.g., housing, employment, education). In turn, this improves health outcomes, specifically for people for long-term conditions, and releases long-term financial and economic efficiencies.

ICBs and partnerships are best placed to lead on PHM by designing tailored interventions for their local populations. It is vital that a broader view of ‘value’ is taken (and over a longer timeframe than a single year) as this will inform decisions on investment into interventions to improve the health of communities, release longer term efficiencies for the NHS and deliver wider societal benefits. Examples of proven interventions include investment in the self-management of chronic conditions such as asthma, COPD, and diabetes.

The range and potential for PHM interventions will be determined by the ambition of local healthcare leaders and decisions makers. The key challenge will be to balance the immediate and acute pressures facing the NHS with a forward-looking approach to the local population’s care needs and associated financial burden.

Akeso and Population Health Management

Akeso has developed various solutions to support ICBs and Partnerships, to address the PHM and longer-term efficiency challenge.

1. A Bespoke PHM Modelling Approach
   We have developed a bespoke PHM modelling approach that benchmarks the cost of health and care provision for ICBs and Places with similar demographics. This was initially developed with NHSE’s Finance Department to identify performance and cost improvement opportunities across all CCGs, using national health, health access, socio-economic, and demographic data. We have further developed the model and combined 46 variables including, cost and access to primary and secondary care, age, ethnicity, rurality, deprivation, diabetes prevalence, and cancer prevalence.
2. Enhancing Business Cases and Cost-Effectiveness in Health and Care Interventions
   We have developed an approach to developing business cases, benefits, and the cost-effectiveness of health and care interventions, that goes beyond the requirements of the 5 Case Model for HM Treasury Green Book Business Cases. For example, we calculate Quality of Life Years (QALYs) and capture economic and societal benefits from the impact of population health management interventions.
3. Data-driven Study for Improved Healthcare Outcomes
   Akeso is currently studying healthcare data to identify potential underdiagnosis rates among adolescent ADHD patients. To achieve this, we are analysing data from the Millennium cohort study and national prescribing rates. The findings of this review will be used to support education initiatives, improve healthcare outcomes and understand the potential for longer-term efficiencies, as well as societal and economic benefits.

Our Population Health Management solutions are designed to deliver tangible outcomes, offering a data-driven approach that empowers our clients to make informed decisions. Through our benchmarking, enhanced business cases, and targeted studies, we provide the tools needed to optimise resource allocation and prioritise interventions. Our goal is to transform healthcare systems, resulting in better health outcomes, reduced costs, and improved well-being for communities.

If you would like to find out more information on how Akeso can support you in delivering financial improvement schemes, please get in touch with Scott Healy, who leads our Financial Improvement offering.