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Summary
This memo aims to explain how the market and public policy changes, including healthcare reimbursement mechanisms, are driving changes in how the hospital engages in population health. This memo also explains the social determinants of health as well as why the hospital needs to work in partnership with other sectors in the community, including the local health department. Therefore, this memo will draw on topics and issues concerning population health and the role of a hospital with other sectors to improve population and community health.
Market Drivers of Population Health and Value-Based Purchasing Mechanisms
Market changes driving a focus on population health include government directives and provision for healthcare IT resolutions, growing use of big data analytics, and the need to restrain the increasing healthcare expenses. When it comes to value-based purchasing mechanisms, private payers will expect to pay out less money for the services used by their clients because of better outcomes that reduce healthcare spending. Value-based purchasing (VBP) mechanisms refer to connecting providers payments to a value-added performance by healthcare professionals. VBP holds healthcare providers responsible for the quality and cost of care they deliver. As a result, its efforts are to decrease inappropriate care by identifying and rewarding outstanding providers. Some examples of VBP programs include Medicare Hospital VBP Program, California Integrated Healthcare Association Program, and Medicare Physician Quality Reporting System and Value-Based Modifier (Chee et al., 2016).
Population Health and Social Determinants of Health
The main policy driving change in health care is the Affordable Care Act (ACA). ACA puts more focus on prevention because the provision of high-quality preventive care assists persons to stay healthy, reduce costs, lead a productive life, and delay or avoid the onset of diseases. Professionals that have long been focused on prevention include nutritionists and dietitians, epidemiologists, microbiologists, public health nurses, health educators and community health workers. Public health professionals are working more closely with other sectors by designing well-positioned delivery and reimbursement systems to effectively address a range of health determinants and focus on prevention. Health systems incorporate service delivery, governance, financing, accessibility to vital medicines, health informatics, and a valuable workforce in maintaining population health. Thus, by collaborating with other sectors, the professionals help improve health outcomes, increase patient safety, and reduce medical errors.
Population health refers to the health results or status of a group of persons and the distribution of such outcomes across the community. On the other hand, social determinants of health refer to conditions that people are born, age, live, or grow with, including social support networks, physical environment, education, socioeconomic status, and accessibility to healthcare. Masic (2018) argues that each determinant has a biological influence on people and population health outcomes. Addressing these social determinants helps improve health and reduce longstanding healthcare and health disparities. Therefore, as a board member, it is crucial to understand these social determinants because of the hospitals role in public health.
Hospitals Community Benefit Obligation
Community benefit is a type of public trust resulting in nonprofit hospitals obtaining tax-exempt status. It covers a full range of activities and services that nonprofit hospitals offer, addressing the impact and cause of health-related needs. When a nonprofit hospital addresses socioeconomic problems in the community it is serving, it helps the population afford health care insurance, decreases medical costs because of preventable chronic conditions, and maintains its personnel needs. ACA has a new community benefit requirement for the hospital, requiring hospitals to complete regular Community Health Needs Assessment. Upon its completion, it is necessary to create and publish an implementation plan (Masic, 2018). The developments provide chances for both hospitals and healthcare centers to establish a way to integrate to attain communal needs, as completion of these plans requires community participation. It is important to understand ACA requirements because they influence population health. Examples of health systems, which have been allocating more of their community benefit dollars outside the hospital and engaging with their community, are The DC Health Matters Collaborative, which has addressed mental health and housing. The Health Anchor Network has also addressed local health disparities by driving medical spending and creating comprehensive plans to sustainably target their investments.
Approaches to Ensuring Accountability and Responsibility in Hospital
Community health entails the collective well-being of community members, and besides living in the same neighborhood, these populations always share health traits, socioeconomic conditions, and ethnicities. The significance of community health improvement entails promoting access to preventive healthcare services, engaging in care decision-making and lowering medication costs. Therefore, community building improves public awareness regarding health problems and willingness to reform, which are significant moves toward improving public health. As the hospital CEO, it will be my duty to ensure each member act as a collective unit to realize a common goal. Some of the approaches that will be used to ensure accountability and responsibility in the hospital include the total quality improvement model (TQM), continuous quality improvement model (CQI), and clinical process improvement model (CPI). The TQM model will involve creating community health, systems thinking, defined processes, teamwork, and organizational management. Using the TQM model, it will be possible to view the entire hospitals commitment to promoting its community benefit obligation and improving population health. CQI and CPI models will be used to ensure each team member is responsible for their role and work closely with other sectors.
References
Chee, T. T., Ryan, A. M., Wasfy, J. H., & Borden, W. B. (2016). The current state of value-based purchasing programs. Circulation, 133(22), 2197-2205.
Masic, I. (2018). Public health aspects of global population health and wellbeing in the 21st century regarding determinants of health. International Journal of Preventive Medicine, 9.
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