What Is Population Health?

Population health uses data to understand the underlying issues that affect health and find ways to mitigate or reduce the risks associated with those determinants across specific groups (like a company workforce).

It’s a vital issue that has been difficult to address, let alone improve, within the current healthcare system. Part of the problem is that it isn’t a widely familiar concept, particularly for employers and their employees, who stand to benefit the most. Below, we discuss why population health is important, why the current system falls short of improving health, and how the right type of healthcare can improve outcomes while driving down the amount companies spend on claims, hospital stays, and staff coverage.

Why population health matters

Individual well-being is deeply connected to community or population health, at home, and at work. People are affected by negative social determinants of health, even in the workplace. These social determinants can include:

• Sedentary habits
• Exposure to smoking and second-hand smoke
• Job-related stress (long hours, high performance pressure, etc.)

A healthier population drives down costs through fewer claims, fewer trips to acute and emergency care, and less (or better managed) chronic illness. To affect positive change in population health, providers need insight into the factors that play a role in patient health. They need data and context to help identify and address risks and to effectively help patients most vulnerable to certain conditions or infirmities.

Poor population health throughout an organization leads to higher absenteeism, lower productivity, and poor employee satisfaction. All lead to increased costs for patients and employers. Increased spending on staff coverages, recruiting, and retention can further drain budgets.

Why can’t the current system help?

The current fee-for-service system is driven by profit and productivity, not whole patient care. This leaves many patients without the full extent of treatment, information, and guidance they need to improve their health. Providers spend only minutes with each appointment and focus on symptoms, handing out specialist referrals rather than getting to know each patient and their underlying issues, causes, and health risks. They barely have time to discuss immediate medical concerns, never mind the social determinants that may be affecting their health.

Patients are passed back and forth between specialists and facilities. Doctors and other medical professionals only see a fraction of the entire picture. Neither patients nor their providers have the information they need to account for underlying issues or to combat them in proactive and preventive ways.

Improving population health with advanced primary care

Advanced primary care is a powerful and effective tool for boosting population health through behavior change. It gives patients and providers the tools and time they need to build trust and work together on improving health. Since most care is delivered at the primary care level, the need for expensive specialty care is reduced.

Care coordination by the primary care team ensures follow-up when a specialist visit is necessary. The team also makes sure to incorporate any new treatment or medication into the care plan, so there are fewer gaps in care and communication.

A powerful analytics platform enables providers to view and generate in-depth reports on population health, disease burden, and co-morbidities. Claims data analysis allows them to further pinpoint areas of risk, evaluate the prevalence of uncoordinated care, and identify high-risk, high-cost individuals who would benefit most from intervention.

Health coaches trained in the transtheoretical change model guide patients through every step of behavior change, so they feel confident in taking control of their health and making practical changes that improve their well-being and quality of life.

The results of advanced primary care are not only improved individual and population health, but increased healthcare cost savings, claims reductions, and higher patient satisfaction ratings.