Roles and Responsibilities
As a Population Health and Value-Based Care Fellow, you will be engaged in comprehensive research projects and practical activities that address critical health issues within the community.
Research Development
- Formulated hypotheses related to pressing population health challenges.
- Developed robust research protocols and methodologies to guide the investigation.
Data Analysis and Community Impact
- Conduct thorough data analysis to assess the impact of health interventions on community outcomes.
- Evaluated how findings could inform strategies to enhance community health and address identified gaps in care.
Intervention and Collaboration
- Design and implement targeted interventions in collaboration with interdisciplinary teams, aiming to improve health outcomes.
- Evaluate and assess with other team members the health goals and the results of interventions.
Patient Counseling and Resource Awareness
- Evaluate and assess resource efficient modes of delivery of care.
- Develop educational materials to raise awareness about community resources and health initiatives.
Value-Based Care Learning
- Deepen understanding of value-based care principles and collaborate with the value-based care team to develop policies that promote high-quality, patient-centered care.
- Learned about key concepts, including:
- Hierarchical Condition Categories (HCC): Understanding how patient complexity impacts care and reimbursement.
- Healthcare Effectiveness Data and Information Set (HEDIS): Familiarity with performance measures that evaluate the quality of care.
- Risk Adjustment Factors: Gained insights into how these factors can be tailored to meet the specific needs of each patient, enhancing care quality and resource allocation.
- Pharmacy and Medical Loss Ratio: Learned about the importance of maintaining a balanced medical and pharmacy loss ratio to ensure quality care and how these ratios influence patient access to necessary medications.
Closing Care Gaps
- Assisted physicians in identifying and closing care gaps, ensuring that patients receive comprehensive and coordinated care.
- Work on initiatives addressing social determinants of health (SDOH) to promote health equity within the community.
Prior Authorization and Education
- Gain knowledge about prior authorization processes and assist in navigating these requirements to improve patient access to necessary services.
- Educate healthcare providers about value-based care strategies, enhancing their ability to deliver effective and efficient patient care.