Population Healthcare Is Health Reform

Michael Christopher
Chief Chigger, CarePrecise Technology

We have heard many people say that the Affordable Care Act is not health reform, but an attempt at health insurance reform. But a broad shift in the focus and delivery of healthcare has begun, shaped in part by the ACA, and poised to bring significant change to American healthcare. At the heart of that change is population-based healthcare.

"With the Supreme Court upholding the ACA, we all now understand that population healthcare is what we're all going to be doing going forward," says Dr. Steven Davidson, senior vice president and chief medical informatics officer for New York's Maimonides Medical Center in a June 28 Modern Healthcare article. What is "population healthcare," what does it have to do with the Affordable Care Act, and what does it mean to industry vendors?

The term refers to "the ability to assess the health needs of a specific population; implement and evaluate interventions to improve the health of that population; and provide care for individual patients in the context of the culture, health status, and health needs of the populations" according to the Association of American Medical Colleges. Population healthcare is a broadening of focus to see beyond the individual patient to the broad context of that patient's health issues, and to understand the issues of the patient's population to better serve both the individual patient and broader communities of patients.

This perspective becomes ever more critical when cost efficiencies are taken seriously into account, as they must be in an "affordable care" paradigm. In a Tufts Managed Care Institute's white paper on population health, we find

"Population-based care involves a new way of seeing the masses of individuals seeking health care. It is a way of looking at patients not just as individuals but as members of groups with shared health care needs. This approach does not detract from individuality but rather adds another dimension, as individuals benefit from the guidelines developed for the populations to which they belong.* Members with a particular disease must be prioritized so that disease management interventions are targeted toward those members most likely to  cost-effectively benefit.**"

The Affordable Care Act package as it now stands places the emphasis on results, rather than on specific means to obtain results. Despite what has been said by opponents, providers are given wide freedom in achieving improved quality and reach of care, and are provided with new resources, such as advanced electronic health records, paid for in part by the taxpayer. Population healthcare is a strategy for deploying these resources and creative latitudes, in a package of practical tactics and achievable objectives, and at scale.

When viewed through the lens of health reform's quality focus, public health data collection and bringing the technologies that enable collection to every point of care, population healthcare is seen as a key - if not the key - strategy for both implementing the provider side of health reform, and rewiring its financial backbone of health insurance.

* Boland P., editor. Redesigning Heath Care
Delivery. Boland Health Care, Berkeley,
1996. pp. 159-163.
** Zeich R. Patient identification as a key to
population health management. New
Medicine. 1998;2:109-116.