How to measure and operate an effective population health management program.

Experts say there is no magic bullet to improve the health status of a given patient population. But a new report from the Conference Board of Canada (CBC) hints at a range of tactics that payers and providers in the U.S. can employ to support their population health management programs.

The report also supports a key tenet in McKesson's Better Health Tour program: Peer learning must be embraced by health care stakeholders across industry segments and across geographic boundaries if transformative health care innovations are to enjoy widespread adoption.

The CBC graded the health of the populations of 29 geographic markets: 10 Canadian provinces, three Canadian territories and 16 countries, including Canada as a whole. Only three received “As”: British Columbia, Sweden and Switzerland. Canada got a “B,” and the U.S. got a “D.”

The CBC based the grades on how well the markets scored on 11 indicators of population health:

  • Infant mortality
  • Life expectancy
  • Mortality due to cancer
  • Mortality due to heart disease and stroke
  • Mortality due to respiratory disease
  • Mortality due to diabetes
  • Mortality due to diseases of the nervous system
  • Premature mortality
  • Self-reported health status
  • Self-reported mental health status
  • Suicides

The indicators, which payers and providers in the U.S. and elsewhere can borrow to measure the success of their own population health programs, are linked to chronic medical conditions such as diabetes, high blood pressure and obesity. They also are linked to a number of behavior and lifestyle choices such as smoking and alcohol consumption. Population health management programs target chronic medical conditions and behavior and lifestyle choices that lead to poor health.

British Columbia got a report card that would make most parents proud: Four “As”, six “Bs” and only one “C” on the 11 indicators.

So what does the health care system in British Columbia do to produce such enviable results? Some numbers from Statistics Canada tell part of the story:

  • Some 46.6 percent of British Columbia residents are overweight or obese compared with 52.3 percent for all Canada residents
  • Some 16.4 percent have high blood pressure versus 17.5 percent for all Canadians
  • Only 15.1 percent smoke compared with 20.1 percent of all Canadians
  • Some 16.3 percent of British Columbia residents say they are heavy drinkers compared with 18.2 percent for all of the country
  • Some 60.4 percent report being physically active versus 53.8 percent for all of the country
  • And British Columbia has 117 primary-care physicians per 100,000 people compared with 106 in all of Canada

A number of population health programs in British Columbia promote healthy behaviors and lifestyles that reduce or control chronic medical conditions. The most notable is the province's Healthy Families BC program. Launched in 2011, the program, which describes itself as “the most comprehensive health-promotion program in Canada,” helps residents manage their own health status and reduce or avoid chronic medical conditions. It offers programs, resources and tools that promote proper nutrition, healthy lifestyle choices, good parenting and healthier communities.

Separately, the Ministry of Health operates the Healthy Living Branch, an agency division charged with setting up population health promotion strategies at schools, businesses and local communities. The strategies cover such issues as tobacco use, healthy eating and food security, physical activity, injury prevention and healthy work environments. Meanwhile, the city of Vancouver is developing what it calls the Healthy City Strategy, a long-term strategic plan that sets 12 population health and well-being goals it hopes to achieve by the year 2025. Recognizing that socio-economic issues have a direct impact on health, the plan will address such issues as childhood safety, homelessness, access to social services and active living.

“Canada has no choice but to adopt a model that focuses on sound primary care practices and population health approaches—particularly preventing and managing chronic diseases—and recognizes the rewards high-quality health care services,” the CBC says, adding, “Population health strategies must target funding for improved information technology, electronic patient records, training and development and innovation.”

The CBC report along with the work being done in British Columbia provides a textbook for payers and providers in the U.S. that want to study population health management programs. Specifically, they offer a set of measures to track population health outcomes, provide examples of working population health programs and identify a list of tools needed to make population health a success, including a comprehensive primary-care network and a robust health IT infrastructure.

Take advantage of the free lesson from your peers across the border in Canada.

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