The Journey to Value-Based Healthcare Starts with Population Health

By Fred Goldstein, MS, Alexandria Skoufalos, EdD and Gregg Masters, MPH

This index blog post served as context and topical community engagement guidance for the Healthcare Leader (#hcldr) TweetChat on February 25th, 2020.

The analytics and transcript of the chat are available here and here, while the digital dashboard is here.

The State of the Market in Population Health – Where are We?

The concept of population health has been around for a while. Framed in 2002 by the landmark work of David Kindig, MD, PhD and Greg Stoddart, PhD, What Is Population Health?’, the then-nascent industry was defined as:

“…the health outcome of a group of individuals, including the distribution of such outcomes with the group,” and takes into account the policies, social factors and interventions that influence them.

While a generic and perhaps ‘roomy’ definition, the vision variably segments populations geographically by community, country or further by employer, payor class or even health plan – both government sponsored or in the commercial domain. In fact, a typical population health ‘enterprise’ can be classically defined as a ‘health plan’ where the members and covered dependents are the population to direct all outcomes efforts or interventions.

While the industry keeps evolving and many other players enter the space — including a growing pool of schools, colleges or departments of population health — from a strategy or footprint point of view there is considerable variability on how to implement, measure and optimize a health system, health plan or other sponsoring entity’s specific population health program.

We will be tracking these developments, trends and innovations at the 20th Population Health Colloquium in Philadelphia on March 30 through April 1. The program was developed in concert with Jefferson College of Population Health, the Colloquium’s exclusive academic partner and the nation’s first college devoted to the discipline.

We expect a large a diverse audience at the Colloquium, as those tasked with a specific responsibility for population health – both strategy and implementation — gather to share insights, best practices and generally advance the state of the art.

The program includes sessions that will explore how the ‘social determinants of health’ drive the outcomes of specific populations, including moving the needle towards the ‘triple aim’; discuss the complexity of re-tooling today’s largely siloed delivery system focused on acute care, into a proactive enterprise that values and promotes health (as opposed to the episodic treatment of disease).

Over the past year we’ve seen continued forays into population heath initiatives on the part of health plans, providers and communities.  This is a trend we expect will accelerate and expand as we learn from experience.

Last year we posted these four questions:

  • T1 What does it mean to be “engaged” in your health? Thinking of yourself in a population health program, how would you define engagement? And, based on that, how would you measure it?
  • T2 Who should be responsible for overseeing a population health program?
  • T3 What can IT and other technologies do to better assist population health programs?
  • T4 What interventions would work for you or those you know to improve their health?

This year, let’s focus the healthcare leader (#hcldr) community tweet chat on the larger issues associating population health with the efforts to improve health at a community level and reduce costs or otherwise move the needle on the triple aim via the advancement of a value-based healthcare delivery and financing system.

First some background

Since last year, the continued escalation of healthcare costs have resulted in more engagement on the part of healthcare systems, government, employers and certainly the community at large. 

A piece by Jane Sarasohn-Kahn included this nugget from Federal Reserve Chairman Jerome Powell’s recemt presentation to the Senate Banking Committee:

“The outcomes are perfectly average for a first-world nation, but we spend 6 percent to 7 percent of GDP more than other countries,” Powell told lawmakers. “So it’s about the delivery. That’s a lot of money that you are effectively spending and getting nothing.”


Per the National Health Expenditure Projections 2018-2027 by CMS, one major finding is that

“… national health spending is projected to grow at an average rate of 5.5 percent per year for 2018-27 and to reach nearly $6.0 trillion by 2027.” 

Six trillion dollars…that’s a lot of money!

Population Health is being touted as the panacea to create cost and quality improvements.  We’ve seen organizations inside and outside the healthcare system coming together in an effort to solve a particular health issue. Examples include: Humana with their ‘Bold Goal’ (listen to recent interview with Humana leaders Caraline Coats, MHSA and Andrew Renda, MD, MPH on PopHealth Week) and the Blue Zone programs, and the YMCA, Lyft and others (expanding access to medical care, exercise programs, and other services).

How can we understand whether these programs having an impact? Would the projected costs be even higher without these interventions?

So here are the questions:

  1. Do you think we have made progress since last year? Cite specific examples of successful population health work you know about.
  2. Which approach(es) do you think are having the most effect?
  3. Will the trend toward Population Health bend/reduce costs? Why?
  4. Are you personally optimistic or pessimistic about Population Health? Why?

For more information on the 20th Population Health Colloquium including the pre-conference faculty and agenda, click here.

We look forward to the conversation…and hope to see you in Philadelphia!


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