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The Struggle is Real — The Top Three Challenges Facing Chief Population Health Officers and Strategies for Overcoming Them

by The Leadership Development Group

We are beginning to see a gradual shift in focus for healthcare organizations, from oversight of sick care to the provision of true health care.  As part of this shift, the role of the Chief Population Health Officer (CPO) is growing in number and importance.

The CPO is dedicated to population health, or community wellness, that focuses on the holistic process of improving health outcomes of groups of individuals through the support of appropriate financial and care models. In the years since the Affordable Care Act, this role has become key in transforming healthcare delivery models to be able to thrive in a value-based care environment. The CPO is charged with expanding organizational capacity beyond traditional clinical expertise to engage the upstream determinants of health in the communities their health systems serve. 

While this important role is much needed, many CPOs face barriers to accomplishing their goals. Empowering CPOs to develop and implement change efforts is the key to successfully delivering on healthcare’s Quadruple Aim. It is this dichotomy that creates the biggest struggle for CPOs.  Below we offer our perspective on the top three challenges facing CPOs and simple strategies for overcoming them.

1. Complex Challenges with Complex Solutions

For population health officers, the challenges and issues they face are often highly nuanced. In population health, the goal is to improve outcomes by leveraging a wealth of data and expanding care teams to proactively address the health needs of a defined population in cost-effective ways. This often leads to complex questions like ‘How do we reverse the factors that put our patients at risk for developing chronic diseases?’ or ‘How can we address social and behavioral health factors?’. 

No two CPOs face the exact same challenges, as health needs vary across populations just as much as they vary amongst the individual people who make up that population. This complexity makes progress slow and hard to measure without established best practices. Population Health Officers must work to establish meaningful ways to understand and measure data related to social determinants of health for patients and communities. CEOs want to see tangible measures of return on investment in the resources invested in population health quickly, further driving up the pressure on population health officers. Developing solutions to overcome these challenges is difficult, yet it’s a vital piece of the population health puzzle.

2. Under-Resourced and Under-Networked

In contrast to other functional departments within health systems that have been around for decades, population health departments are often the smallest due to their recent creation. In addition, they often get a much smaller percentage of the overall budget, resulting in lower staffing levels. In a recent survey, 79% of respondents ranked budget or financial concerns among their top three population health challenges. This under-funding is contrary to the idea that population health officers are meant to enact change on a large, systemic scale.

While most CPOs see themselves as change agents of population health, they not only often lack resources compared to their peers but often lack proper networking within their own organizations, as well. When the population health function is not embedded in the organization in a meaningful way, major roadblocks can occur impacting how effectively population health initiatives across the organization are implemented. To be successful strong collaborative relationships are needed with both department and service line leaders across the organization. For example, a strong partnership with the finance department helps to ensure population health plans are developed in a financially viable manner. And, strong relationships with HR could help ensure hiring and talent development practices cultivate the necessary skills to drive population health strategy. These relationships require thoughtful time and effort to cultivate and often have yet to be built up.

3. Lack of Structural Support

As organizations navigate how to adapt the population health department into their current structure of reporting, CPOs are finding that where the department reports greatly affects how the role and the department function as a whole. This directly impacts the department’s ability to create meaningful change on the organizational level, something that is key when trying to accomplish systemic change. When population health leadership is not positioned high enough within an organizational structure it becomes increasingly difficult for those tasked with population health responsibilities to build and proliferate a compelling vision for change across the organization.

Population health success also requires fundamental shifts in clinician behavior and payment models. New data from the Centers for Medicare & Medicaid Services (CMS) shows a slight increase in the use of Z codes to document social determinants of health, however, overall usage remains low. A number of barriers exist to increasing documentation, most notably a lack of financial incentives since Z code claims are not generally used for payment purposes. A recent study found that only 23% of clinicians ask patients about social needs, only 22% review social needs in medical records, and only 35% assess social needs in clinical decision-making.

Structural changes to the ways clinicians provide care and code and bill for services are necessary to ensure population health efforts and goals are financially viable. Health systems that are unwilling to advocate for necessary external changes in the healthcare environment, or unable to make the necessary fundamental shifts internally leave their population health officers unable to deliver on the promises of improving health outcomes while reducing costs as they were hired to do.

Organizational Benefits of Fully Investing in the Success of Population Health Leadership

When an organization invests fully in population health leadership, they increase the quality of care, improve the health of the populations they serve, and reduce the per capita cost of care. Based on our extensive research in the areas of population health leadership and depth of experience supporting leaders, organizations, and teams who are implementing population health strategies, our team at TLD Group believes that investments in leadership development can be a difference-maker for organizations looking to drive success in population health. So, what would these investments look like?

Accelerated Assimilation Coaching

Accelerated Assimilation solutions can help support leaders stepping into new population health roles by intentionally building their internal networks across the workplace and helping to meaningfully embed the role and function into the broader organization. This is accomplished through a custom-designed executive coaching program, intended to support leaders who are stepping into important strategic roles within their organization. With the right executive coaching partner supporting the effort, leaders create an action plan for moving forward their vision for the important function population health can play for the system.

Team Development

Investing in team development helps support collaborative population health projects. Our expert consultants will work with a small set of stakeholders to support them in creating and implementing the population health solution they need. This drives change while also providing consultation on process design and infrastructure needed for the population health department to thrive.

Leadership Development

Our cohort-based leadership development academies can help shift the organizational mindset in support of population health efforts. Our Client Relationship Managers are experts in designing and delivering experiential programs and opportunities that build leadership skills and drive forward change efforts. By using the 70/20/10 model of learning and our expert knowledge of population health leadership competencies, our team can help your organization design and deliver a solution that builds commitment to change efforts throughout the organization. This is meant to help empower team members to become change agents in their organization’s journey towards improving population health.

Final Thoughts

Population health is an important investment in the future of the healthcare sector, but those leading the way are not getting the resources and support they need to thrive. Investing in leadership development solutions can help blossoming population health officers lead their departments and step into the change leadership required to achieve the results organizations want to see.

Interested in learning more about leadership development for your population health roles? Get in touch with us — we’ll help you accomplish your population health goals.

Topics: Leadership Development, Healthcare Ecosystem, Leadership, Leadership Resources, Executive Coaching, Team Development, Collaboration