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Group Project: Chronic Disease Population Health Needs Assessment Your health care system is actively managing the COVID-19 pandemic, transitioning to a value-based care model, and considering ACOs, bundled payments, and population health management initiatives

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Group Project: Chronic Disease Population Health Needs Assessment

Your health care system is actively managing the COVID-19 pandemic, transitioning to a value-based care model, and considering ACOs, bundled payments, and population health management initiatives. After thorough due diligence, the system decided to create a new PHM program for treating chronic disease. The new program is to focus on treating chronic disease, prevention, and management. This population health program requires continuity of care and management of care transitions that maintain an ongoing connection with patients as they live their lives. To implement the initiative financially and operationally, care models must be fundamentally assessed for patient and community needs. For this scenario, you are hired by the system to provide strategic consulting services to the system's chief population officer (CPO) by ensuring the system's population health management strategy is less depending on high-resource, low-frequency interaction but shifting toward frequent, low-intensity interactions. The CPO tasked your group to provide an executive summary (ES) that includes:

?             Discuss the risk factors and circumstances that lead to the development of chronic diseases.

?             Conduct a need assessment analysis (compare and contrast, ROI, GAP Analysis, etc.) and the impact of financial models' incentives for prevention and chronic disease management.

?             Consider what metrics are needed to assess and measure progress in incorporating patient and other stakeholders' perspectives into the need assessment study.

?             Prepare your (ES) in a three-page paper (title and references pages do not count toward the page count).

?             Cite 10 recent high-quality references; four (4) of them are from recent peer-reviewed articles.