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Resource Overview

Population Health Management (PHM) is an evolving concept encompassing a suite of emerging technologies to aggregate, analyze and use data to improve clinical and financial outcomes.  PHM tools enable health centers to identify, monitor and target care to patients within a population. Resources in this section provide a conceptual foundation to help health center staff deepen their understanding of PHM and how the social determinants of health can be used to improve outcomes.

PHM and SDH Concepts and Overview Resources

The HITEQ Center Podcast

Sharing Virtual Care Success Stories and Lessons Learned; Episodes in 2022

HITEQ Center 0 6489
HITEQ is highlighting stories of leveraging the EHR, health IT, digital health tools, and other virtual care supports for health center recovery and stabilization during the COVID-19 pandemic and thereafter in this series of podcasts. We are lifting up stories that demonstrate the promise of digital and health IT tools to address the timely needs of health centers and their patients, emphasizing those that support high value, equitable care for all health center patients and that reduce provider burden.

[Video] FQHC Value Based Payment Basics

Developed with Starling Advisors in 2022

HITEQ Center 0 10246

In this 25 minute video we cover the basic mechanics of how FQHCs are paid, the prospective payment system, and how it is evolving over time. We also review the spectrum of value-based payment arrangements using the HCP-LAN framework as a guide. We also discuss the capacity needed to be successful in each of those payment categories. Patient attribution process, including why that data is so critical in value-based payment arrangements, and what questions to ask payer partners about attribution processes are also reviewed. Lastly, a real value-based payment arrangement and related considerations are reviewed.

SDOH Data Dashboards Module 4: SDOH Dashboard Design - Advanced

HITEQ SDOH Data Dashboards Series

Molly Rafferty 0 12749

The Social Determinants of Health Data Dashboards training is a four-module series. Modules range from about 8 minutes to 12 minutes in length. Module four provides advanced-level information on using social determinants of health data and dashboards for facilitating and tracking social needs referrals, conducting predictive analysis with social determinants of health and health outcomes data, and using social determinants of health data to improve reimbursement for addressing social needs.

SDOH Data Dashboards Module 3: SDOH Dashboard Design - Intermediate

HITEQ SDOH Data Dashboards Series

Molly Rafferty 0 13033

The Social Determinants of Health Data Dashboards training is a four module series. Modules range from about 8 minutes to 12 minutes in length. Module three provides intermediate level information on collecting social determinants of health data and using data visualization for effective dashboards with stratification of data.

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Acknowledgements

This resource collection was cultivated and developed by the HITEQ team with valuable contributions from the National Association of Community Health centers (NACHC) as well as HITEQ's Advisory Committee and many health centers who have graciously shared their experiences with HITEQ.

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The Quadruple Aim
Quadruple Aim

A Conceptual Framework

Improving the U.S. health care system requires four aims: improving the experience of care, improving the health of populations, reducing per capita costs and improving care team well-being. HITEQ Center resources seek to provide content and direction aligned with the goals of the Quadruple Aim

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