Improving Population Health Care in the United Sates

Defining Population Health Care

When defining population health care there are many definitions, but the term was summed up best by C.E.A. Winslow when he stated that population health care is, “the science and art of preventing disease, prolonging life, and promoting health through the organized efforts and informed choices of society, organizations, public and private communities, and individuals.”  This definition provides an obtainable model for the public health care system.

Population Health in the United States

The recent statistics on U.S. healthcare shows a high rate of spending yet a lower life expectancy and overall worse outcomes when compared to countries with comparable earnings.   It is estimated that the U.S. spends at least five times the amount that Canada spends on healthcare with Canada being the second highest country in spending.  Yet the life expectancy in the U.S. of approximately 78  is lower than many comparable countries in the study.  The study included Germany, Japan, Canada, Denmark, Australia, Norway, the UK, Sweden, France, New Zeeland, and the Netherlands which all have life expectancy rates above 80 years old.

So Why is the U.S. Behind Other Countries?

Part of the problem is that eighty percent of what affects health outcomes is lifestyle behaviors and socioeconomic conditions.  Some of these factors that can have a significant effect on life expectancy and health outcomes even with appropriate health care include:

  • Smoking
  • Sexual activity
  • Air and water quality
  • Employment
  • Income
  • Education

The importance that these lifestyle and socioeconomic factors play in health outcomes is important enough that it should become part of the healthcare delivery strategy in the United States.  This can be implemented by providing health intervention systems in the social support systems such as law enforcement, religious organizations, and social services.  To provide the best possible outcomes for U.S. citizens, the areas that need to be addressed in the social sector include:

  • Providing healthy eating options
  • Ensuring affordable housing
  • A reduction of violent crime
  • Access to dental care
  • Implementing education programs
  • Promoting job growth
  • A safe environment with clean water and air

What Are the Missing Factors in Population Health Solutions That Are Already Implemented?

One of the biggest difficulties with current public health solutions is that they function off of data received from encounter-based medicine practices.  This provides limited data on such things as social determinants when related to healthcare data.  This causes the health systems to manage on the principle of per member per month charges.  This same encounter-based approach is used in the claims processing which reduces the data to procedures and tests that are allowed and not allowed instead of addressing all facets of care that went into the original encounter.

So How Do You Achieve BBetter Health Outcomes for the Population?

To change the overall population health, it will require health organizations to take an active interest and invest in the people they are treating.  It is important to focus attention on patients who are developing a rising risk of a poor health outcome and implement changes to hopefully alter their health path instead of simply treating them once they have become the highest risk level and will not benefit from early intervention anymore.

To be successful, it is important to understand costs and patient outcomes so that the new equation for health management calculates the Clinical Outcome Achieved by the Total Patient Investment to determine how much it costs to increase the patient’s health outcome by one unit of measure.  To achieve this new data, it is important that the healthcare industry collect true individualized patient data instead of relying on average costs of all patients.

The United State’s health statistics show us that how the country manages their population health needs to change to help improve the life expectancy and overall health outcomes for its citizens.  This can start with a better understanding of the cost of population health as well as all of the factors that are involved in creating the patient’s overall health profile.  This combined the true data can help change the way population health is defined in the U.S.