Insights on Population Health Management, Thanks to the Closing Seconds of Superbowl XLVI

Only the Disease Management Care Blog can find population health management lessons from yesterday's Superbowl.

With only 57 seconds left in the game and the Giants in possession of the ball at the six yard line, elite running back Ahmad Bradshaw got the hand-off.  He was only a few steps into the play when he simultaneously realized that the Patriots were purposely not tackling him and that his quarterback, Eli Manning, was shouting at him to not enter the end zone. That's because Mr. Manning knew that a quick touchdown would turn possession of the ball back to the Patriots and give their star quarterback Tom Brady plenty of time to stage a comeback.

It was the difference between running out the clock and getting points on the board.

Against every instinct, Mr. Bradshaw slowed, turned and tried to sit down, only to end up squatting his way butt-first into Super Bowl history.  Fortunately for the Giants, while the Patriots did get possession of the ball, Mr. Brady's passing game was stymied and the Giants won.

The Actuaries:

The DMCB thinks of Eli Manning's cunning as a demonstration of the actuarial sciences, where the past experience of Tom Brady's passing magic was projected into a future of time-outs plus clock-stopping sideline plays that were calibrated with situational awareness and educated guesswork.  Such is the business of health insurance where the beneficiary population, the mix of services and the cost per service are used to make huge bets on a premium.  No wonder Eli had a some "eye of the tiger" about him when he was standing on the sidelines.

The Providers

The DMCB thinks of Ahmad Bradshaw as an archetype of those elite docs who live to make the diagnosis (with end zone ahead and ball in hand) and cure it (i.e. a touchdown).  Asking a provider to not commit all possible resources for patients ends up like Mr. Bradshaw's ungainly scoring: not only isn't it pretty, it seems to happen anyway.  Such is culture of U.S. health care where the latest technology is combined with professional judgement to drive revenue. Last but not least, Mr. Bradshaw was ironically credited with the game-winning touchdown.

As providers transition into assuming more risk with a variety of bundled payment, gainsharing and global budget arrangements, they would be well advised to think about the logic of running out the clock and saving as much on utilization as they can.  If they don't, they may gain plenty of revenue points but will end up losing when the books close on the final seconds of the fiscal year game.