October 28, 2014
Related Links2017 Population Health Summit: Five-Year Retrospective: How Far We Have Come, and What Lies Ahead 2016 Population Health Summit IV: Working Across Sectors to Address Social Determinants of Health 2015 Population Health Summit: “From Innovators to Early Adopters: A Closer Look at Bridging Health Care and Population Health”
Despite growing evidence that nonmedical determinants (such as housing, access to affordable healthy foods, and opportunities for physical activity) have a disproportionate impact on a population’s health, the business case for investing in healthy communities remains ill-defined. Without a clear understanding of the financial return on investment, attention to population health will continue to lag.
The summit brought together State and national leaders to discuss examples where delivery systems and communities have successfully invested in geographic population health; the business case for investments in population health from the payer perspective; potential provider payment models for expanding investment beyond the clinical care of specific patient populations; and alternative financing models for community health investment being used by states, financial institutions, and private investors.
Dr. James R. Knickman, President and CEO, NYSHealth, offered an introduction to the summit by noting the need to think more broadly about population health and prevention to help people lead healthier lives. Bridging the intersection between public health and medical care delivery systems and investing in communities are key factors in improving population health.
Keynote speaker Dr. David Kindig, Emeritus Professor of Population Health Sciences, University of Wisconsin-Madison School of Medicine and Public Health, gave an overview of what is needed to improve overall health and reduce or eliminate health disparities, including developing and securing dependable long-term revenue streams; aligning health improvement goals and objectives with the missions of other sectors; and encouraging health care systems to engage with the public and private sectors to invest in the social factors that impact the health of a population, and not just the medical factors. Dr. Kindig stressed that until feasible, appropriate financial incentives are in place, population health improvement will not be achieved.
Opening plenary speaker Courtney Burke, Deputy Secretary for Health, New York State, provided an overview of the State’s commitment to population health. She outlined current initiatives being implemented to advance the health and wellbeing of communities across New York State—Prevention Agenda 2013–2017, State Health Innovation Plan (SHIP), and the Delivery System Reform Incentive Payment (DSRIP) program, all of which are focused on the Triple Aim of improved health, better care, and lower costs.
The first panel, moderated by Dr. Marc Gourevitch, Chair of the Department of Population Health, NYU School of Medicine, set the stage for discussion about initiatives that build bridges between population health and medical care. The panelists offered examples of provider/payer collaborations and population health improvement measures being undertaken at the national, State, and local levels.
Gregory S. Allen, Director, Program Development and Management, Office of Health Insurance Programs, New York State Department of Health, delved deeper into the State’s efforts to improve the health of communities by changing how care is delivered. He emphasized that the underlying theme of DSRIP is collaboration at the community level and stressed that health care issues will not be solved without addressing social determinants, such as housing and transportation.
Kate Ebersole, Principal of KEE Concepts Consulting and former Director of Community Health Improvement and Care Transformation at P2 Collaborative of Western New York, spoke of P2’s use of standardized reporting metrics in bringing a variety of partners to the table, including three large health systems and several community-based organizations. Lessons learned as a result of these efforts included the importance of having a neutral convener to bring stakeholders together and the critical need to engage patients in their care, as patient engagement is an integral part in advancing population health.
Dr. Paloma Izquierdo-Hernandez, President and CEO of Urban Health Plan, a federally qualified health center in the South Bronx, offered a health care systems perspective to advancing population health within a community. Dr. Hernandez spoke of both patient-level and system-level approaches and noted several ongoing communitywide strategies, including nutritional counseling, community supported agriculture, job training, and a charter school that helps young people achieve their highest potential.
Dr. Monica Peek, Assistant Professor, Division of General Internal Medicine, University of Chicago, concluded the first panel discussion with a case study of a business investment with Walgreens that has led to health improvements in communities of Chicago’s South Side. Dr. Peek emphasized that in order to get both private and public sectors on board with advancing population health, making a strong case for the incentives that the for-profit sector can expect to gain from investing in population health is essential.
At a lunch session moderated by Jacqueline Martinez Garcel, Vice President, NYSHealth, Dr. John Whittington, Lead Faculty for the Institute of Healthcare Improvement’s Triple Aim initiative, explained the general principles for achieving better health care outcomes, better quality care, and lower per-capita costs. Dr. Whittington outlined several important components in advancing population health—including the identification and development of key leadership for building project portfolios that will yield measurable results. He also noted several potential roadblocks that could derail population health efforts, such as the duplication of community services rather than better coordination of existing ones.
The second panel, moderated by Dr. Anthony Shih, Executive Vice President, New York Academy of Medicine, focused on alternative financing mechanisms that could have the potential to positively impact population health efforts. John Auerbach, Senior Policy Advisor to the Director, Centers for Disease Control and Prevention, began with an explanation of the conditions that created Massachusetts Prevention and Wellness Trust Fund (Trust), the first-in-the-nation trust fund focused on population health. The Trust is committing $60 million over four years to address health inequities in communities that have the highest burden of disease in Massachusetts.
Sara Rosenbaum, Professor of Health Law and Policy and Founding Chair, Department of Health Policy, George Washington University School of Public Health and Health Services, spoke about community health benefits, hospital-subsidized community improvement services, and community benefit operations provided by tax-exempt hospitals and other public health agencies.
Megan Golden, Senior Fellow, Institute for Child Success and NYU Wagner Fellow, gave an overview of pay-for-success financing, also known as social impact bonds, as a way for investors to align positive social impact with financial returns. As an example, she described a successful collaboration between Goldman Sachs and other stakeholders in funding a program in New York City aimed at reducing the recidivism rate for youth offenders.
Amy Gillman, National Program Director, Local Initiatives Support Corporation, explained the role of community development financial institutions in aggregating financial resources for health-related investments in neighborhoods with the highest health disparities—communities that traditional investors have often avoided. Financing affordable housing can also be about investing in family wellbeing and health, such as good ventilation, community gardens, and onsite resources and services.
Dr. Howard Zucker, Acting Commissioner of Health, New York State, offered closing remarks on the role of providers, payers, and policymakers in investing in and promoting population health in New York State. Pushing prevention to the top of the State’s priorities is a key objective. To do so, he emphasized the State’s efforts in advancing population health through the many initiatives mentioned throughout the summit, such as DSRIP, SHIP, and Prevention Agenda 2013–2017.
Dr. Jo Ivey Boufford, President, New York Academy of Medicine, summarized the key themes of the summit, including the need to think about benchmarks and targets, the importance of patient involvement, and the value of having a learning community exchange information and lessons learned. She also noted the advancements in population health over the past year in comparison to last year’s summit. Finally, Dr. Boufford stated that while advancing population health is a very complex—yet not impossible—process, the political will exists to move the agenda forward.
Read a white paper on the summit’s key ideas, issues, and recommendations, as well as additional opportunities that New York State might pursue to sustain the investment needed to make New York the healthiest State.
Download the conference speakers’ PowerPoint presentations below: