Population Health

Distinctions in the health outcomes of specific groups of patients with similar demographics is the focus of Population Health management, with a particular emphasis on preventing negative health outcomes for high-risk patients. These distinctions have led to the creation of a wide spectrum of strategies to identify patients that are costly to the healthcare system. These high-risk patients are the focus of most population health initiatives created by insurers and are the catalyst for an entire industry of companies dedicated to creating interventions that improve both clinical and financial outcomes for these patients.

The Learning Objectives for this module will allow you to:

• Describe the major Population Health companies and their footprints across their key payer, IDN, and health system partners
• Define what diseases, therapeutic areas, and types of interventions are the focus of population health initiatives
• Describe some of the high-profile Partnership Health collaborations between key healthcare organizations including pharmaceutical manufacturers, insurers, and provider organizations
• Explain how payers have tailored their benefit designs and formulary coverage to support their population health initiatives
• Understand the results of population health initiatives and the factors that characterize successful population health strategies

Population Health Management is now a key component of the transition to value-based reimbursement and a core competency that must be mastered by healthcare stakeholders.