What is Population Health and Why Does it Matter to Starling
What is Population Health?
Much of the discussion about the future of healthcare focusses on moving to a Population Health (or “PopHealth”) approach to care. There’s lots of confusion about what that means. Contrasted with the way medicine has been practice in the United States for many years, where providers address the concerns of patients who present themselves for care, population health shifts the focus to the health of entire populations, both those who seek care and those who do not.
A population can be defined geographically, socio-economically, by chronic disease burden, or by their affiliation with a health care provider, and the population’s health status is measured by clinical indicators such as whether the patients receive appropriate health screenings and evidence-based care for chronic illness. Pop health also explicitly acknowledges the influence of the “social determinants of health” including the population’s social, economic, and physical environments, personal health practices, individual capacity and coping skills, and availability of health services.[1]
Why Does Population Health Matter to Starling?
Starling’s current contracts with many health plans identify patient populations who have chosen or been assigned to our providers. Most are associated or “attributed” to us via a primary care provider, but some are attributed to specialists if the specialist is the main provider from whom those patients seek care. The health plans expect Starling to assure that the populations attributed to us receive quality care as measured by clinical indicators captured in claims or reported by Starling. In addition, if Starling providers are able to manage the care of patients in our population more cost effectively than would be expected in our community, many plans offer Starling an opportunity to share in those savings.
The plans in which these kinds of population health measures apply are:
- Aetna: Commercial and Managed Medicare
- Anthem: Commercial and Managed Medicare
- ConnectiCare: Managed Medicare
- United: Managed Medicare
- Wellcare: Managed Medicare
Stay tuned for my next post about how we’re positioning Starling to succeed in managing population health.
[1] Adapted from the definition of population health articulated David Kindig, MD, PhD and Greg Stoddart, PhD, American Journal of Public Health, v.93(3); Mar 2003