We need better health at lower cost. Many of our health outcomes are not what they should be, and we have widespread disparities in health status. Our health care costs are increasingly unaffordable, and individuals, employers, and government agencies are struggling to afford the cost of care. And in the coming years, the age wave and the rising prevalence of lifestyle-driven chronic disease will place even more pressure on the health care system and the national economy.
Population health improvement (sometimes called population health management) is emerging as a strategic approach for achieving better health and lower cost. Population health improvement can be practiced in the clinical setting, the community setting, or ideally across clinical and community settings for the good of specific populations. The population may be defined as the members of a patient panel, enrollees in a health plan, employees of a firm, beneficiaries of a public program, or residents of a geographic region. Whatever the setting, the objective is to optimize health and health supports for specific populations at the lowest necessary cost.
We can see the shift toward population health improvement in the purchasing strategies implemented by large employers, Medicaid, and Medicare. More of these purchasers are looking for ways to improve health and reduce costs for the populations they represent. We can also see population health principles in the performance requirements of public and private grant funders. Today’s funders are expecting community service providers to collaborate in order to produce better outcomes relative to cost for specific populations.
The population health imperative is also being widely promoted by national and state level research organizations. The Institute of Medicine, think tanks, and provider associations are documenting and predicting the continuing evolution toward population health improvement.
This is an important time to be building and strengthening capabilities in population health improvement. It is true that the system is in flux and there is much work to be done in defining delivery and payment systems for population health improvement. Yet there is no doubt that purchasers and funders are expecting much more than a demonstration of productivity and quality in service delivery. They want to see better outcomes relative to costs for specific populations, and organizations that can meet this expectation will be in better position to sustain their funding and achieve their mission.