“Population health.” It is a term that is widely used in health care, but not universally understood. Some definitions of population health emphasize outcomes. Others focus on measurement. Still others emphasize accountability. So what does population health truly mean? Who is responsible? What impact does it have on our current health care environment?
What we do know is that population health is a term frequently used in both health care and public health. The shift toward population health, with its emphasis away from volume and toward outcomes, preventive care, and value-based reimbursements is definitely in the future of health care in rural Nebraska. Despite significant challenges, rural healthcare leaders are embracing population health as their future—not because it offers economic salvation, but because it makes perfect sense for their mission: to provide care for the community.
Population health management is being pursued by many healthcare leaders, but it’s a hard strategy to manage when the population is small and spread out. That’s the difficulty facing rural health care providers, who have long dealt with an older and sicker demographic, difficulty in finding physicians, and economic constraints, and are now pushed to the brink by health care reform.
Population health—like everything else in health care—is resource-intensive. Many of the requisites for population health are more easily found in urban areas, where there is more of everything: more primary care physicians and sub-specialists, more money to spend on very expensive healthcare information technology, and greater economies of scale for purchasing and leveraging with vendors and payers.
Of course, an essential component in population health is ready access to a population. As obvious as that sounds, in large swaths of the United States that’s not such an easy proposition.
Still, leading health care providers in non-urban and rural areas say they can make population health work for the people they serve—and for their organizations—despite the obstacles. Among the approaches: cooperation rather than competition among equals, clinical integration that emphasizes providers’ strengths rather than weaknesses, local engagement with a community rather than local ownership of all the components of care, and a focus on primary care rather than specialty care.
As the health care system works to integrate primary care and public health, family physicians and the patient centered medical home will have more opportunities to partner with community resources and advocate for policies and interventions in these communities aimed at influencing social determinants of health and improving health outcomes