Posted by Deborah Caputo Rosen
We have been thinking about population health at Wilson-Stronks LLC. Soto notes, “(M)any see attention to population health as a potent opportunity for health care delivery systems, public health agencies, community-based organizations and many other entities to work together to improve health outcomes in the communities they serve.” (1)
Although there are a variety of definitions of population health they share some common themes. Population health has a wider scope than traditional public health because it explicitly includes the health care delivery system itself, and its accountabilities. Not only are health outcomes measured but also the factors that influence them—social determinants of health and disease prevention efforts. A population health management focus includes the active reduction of health disparities and the pursuit of health equity.
Health care administrators have taken a renewed interest in health promotion and disease prevention. One of the drivers for this has been the Patient Protection and Affordable Care Act (ACA). Regardless of your political opinion of “Obamacare”, the law creates structure that motivates healthcare organizations and realigns their interests. Increasing insurance coverage increases access; especially for populations traditionally disadvantaged from preventative services, screening and the resultant early case-finding and improved outcomes (with associated lower healthcare and societal costs).
CMS and the Patient-Centered Outcomes Research Institute, among others, plan to track and study patient results as a research-based means to improve quality. The ACA includes a variety of approaches to increase both the quantity and quality of primary and preventive care, including the development and funding structures of Accountable Care Organizations (ACOs).
A new IRS requirement under the ACA mandates health care organizations and public health systems to engage in community health needs assessment every three years. Communities, including their health needs and health resources, must be described along with a prioritized implementation strategy to meet those needs. Both health outcomes and accountability measures are required.
“One size does not fit all” is the lens through which Wilson-Stronks always has advocated and offered services. The new reality of the world of health care provision requires that the population eligible to be served must be identified, its needs and current resources characterized, and the interventions individualized to meet those needs. This offers renewed opportunity to consider culturally-responsive and linguistically effective communication in the design and delivery of care.
Finally, target outcomes must be identified, risk-adjusted metrics developed and mutually accepted and information must be sharable to promote evidence-based promising practices. In the highly competitive and diminishing margins of health care provision, patients and providers alike will benefit when, to quote Thomas Friedman’s book, The World is Flat.
1. Soto MA, “Population Health in the Affordable Care Era”. Academy Health, 2013, pp.2-6