Measuring Population Health and Healthcare Quality Outcomes

From Concept to Reality

Population health has been studied by many public health and policymakers since the mid-twentieth century. Their work has facilitated great advances in areas such as immunizations, public safety, sanitation, and communicable diseases. Now, terms such as population health and population health management are moving beyond traditional definitions to describe new models of care. The challenge is to measure the value and effectiveness of these newly defined models.

The Affordable Care Act (ACA) has created a paradigm shift in how care is delivered and paid for, and as such, providers are faced with the task of moving from volume to value, while still taking care of people. Providers need to address not only the clinical aspect, but also determinants of health within the population. Under this new paradigm, healthcare is no longer viewed simply in terms of admissions, visits, or episodes of care, but also in quality and outcomes. Focusing on populations while still individualizing patient care and monitoring the quality of care delivered is important: physicians are paid on both the value of such care delivered and the outcomes.

Since the ACA mandates the use of electronic health record (EHR) systems, claims data, disease registries, and even feedback from consumer advocates, these sources provide an opportunity to collect quality outcomes and population health measures and potentially can be used as clinical decision-making tools. The integration of these data sources, however, can prove to be challenging as care and measurement move from the reactive to proactive and preventative. This shift in approach to healthcare affects how we think about measurement—both the health of the population and how well we treat patients.