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Innovations in Population Health Management Could Benefit from Command and Control Techniques

Posted by Thomas Edwards on July 10, 2019 3:00 PM EDT
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Chip's recent blog post (July 5th) espousing the reluctance of some managers and leaders to inspire their teams to achieve more...

...strikes me as an interesting entry in support of how to improve career wellbeing and community wellbeing within the context of contemporary organizations.  In the "networked economy" of today, it's hard to argue against the potential power of engagement by letting go of top-down, direct control management systems that spend more time on holding good people accountable to actions set against bad strategy, versus inspiring and engaging them in pursuit of breakthrough results.

Applied innovations in Management (AIM) truly pushes managers and leaders to let go of some of their power over the specific actions people they lead take and allowing some openness and measured risk-taking to take hold.  But, alas, Chip's expertise and focus on improved management and leadership techniques in modern organizations trumps mine.

However, as someone who has been giving thought to ways to improve population health and reduce the drain on healthcare resources and services by having healthier citizens and decreasing demand on the healthcare system, I must say that I tend to think a traditional management model may be worth considering.  In the context of helping create sustainable improvements in people with chronic disease conditions, applying innovation may look like traditional "command and control meets peer support" model.  Indeed, applied innovation may suggest that we need to be going back to a more structured, accountable and focused system for setting individual health action plans, providing oversight, employing a team approach, providing some sort of consequence for non-compliance and compensation for compliance to the "HIP" (healthy individual plan) and communication around success, celebration about the success and collaboration and coordination so others can experience the same success in a sustained and yet confidential manner.

We see some of this happening in the health benefits arena with employers who embrace CDHP programs like HSAs, HRAs, and wellness programs (CDHP is an acronym that stands for "consumer-driven health plans").  On a daily basis, we see more and more focus on improving the knowledge of people to become better consumers of healthcare services and products.  And we even see new models in governmental insurance programs like Medicaid by more movement towards the "managed services" model.  

Yet, we fall short of providing adequate rewards to those people who are able to follow evidence-based regimen, provide transparency to the healthier lifestyles they are leading, accept accountability for the commitments they make and are rewarded when good things result.  Until we are able to change our broad culture to become truly good stewards of their health and to reward the improvements made whether those be based on cost improvements (lower claims), metrics improvements (better weight, BMI, specific chronic health conditions movements and stronger sustained health behaviors, then we will have simply put more financial pressure on those who are healthy and can pay, while not doing anything meaningful to reduce the cost burden of the unhealthy members of society who might be doing nothing to improve their wellbeing-whether that be in physical, social, community, career or financial dimensions.

So, maybe some PSDA and teamwork-based but accountability enforced command and control as it relates to helping every person be HIP-centered.....

Sometimes innovation is simply applying an old, and effective model in an entirely new context?!

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