Population Health Management

Population health management involves a broad range of activities aimed at improving the health outcomes of a specific population. These activities may include preventive care, health education and promotion, disease management, and care coordination.

By focusing on the health needs of a particular population, such as a community or patient group, population health management aims to address health disparities, improve health outcomes, and reduce healthcare costs. This approach is becoming increasingly important as healthcare shifts towards a more value-based model that prioritizes quality of care over the quantity of services provided.

Overall, population health management can have a significant impact on the health of individuals and communities.

We take pride in maintaining excellent HEDIS Scores.

HEDIS (Healthcare Effectiveness Data and Information Set) is a set of performance measures used by health plans to evaluate the quality of care they provide to their members. The measures cover a broad range of clinical areas, including preventive care, chronic disease management, behavioral health, and utilization of healthcare services.

HEDIS scores are a way to track a health plan's performance on these measures. Scores are calculated based on the plan's performance on each individual measure and are often reported as a percentage. Higher scores indicate better performance on the measures.

Health plans may use HEDIS scores to identify areas where they need to improve the quality of care they provide to their members. They may also use the scores to compare their performance to other health plans and to set goals for improvement.

Overall, HEDIS scores can be a valuable tool for assessing the quality of care provided by health plans and for identifying areas where improvements can be made to ensure that patients receive the best possible care.

Notable Achievements:

Controlling blood pressure control in >94% of our population with or without diabetes. (Control defined as blood pressure < 140/90 for prior year)

Acheiving HgbA1C < 9mg% in more then 86% of diabetics. This number is expected to improve with new medicare criteria for use of continuous glucose monitoring. 

Acheiving > 80% proper treatment protocol implementation in patients with coronary artery disease. (Includes patient antiplatelet usage, beta blocker therapy, and cholesterol and blood pressure control.)












Curtis Dalili, M.D.
Thomas Lewis, M.D.
William A. Arnold, M.D.
Miciara Hernandez, M.D.
Lauren Bloom, M.D.
Maria Pimenova, M.D.
Katelyn Reismiller, PA-C
Tina Barrett, APRN
Tammy Donnick, APRN

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