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The purpose of this paper is to investigate the relationship between ownership type and population health initiatives adopted by hospitals using the 2015 American Hospital Association data.

Hospitals of various sizes, ownership structures and geographic locations are represented in the survey. The outcome variables of interest include measures of hospital population health activities.

Findings indicate that nonprofit hospitals are most likely to express commitment to population health and participate in population health activities, with for-profit hospitals being least likely. Implications for policy and practice are discussed.

This study demonstrates that discrepancies in population health approaches exist across ownership status – particularly, nonprofit hospitals appear to be the most likely to be involved in population health efforts.

As we continue to push for population health management in the hospital setting, grappling with the definition and purpose of population health management will be essential.

Overall, these results suggest that nonprofit hospitals are more likely to be implementing population health efforts than for-profit or government-owned hospitals.

Although there are several studies on population health in hospitals, this study is the first to investigate the relationship between ownership type and population health initiatives adopted by hospitals.

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.

Changes in demographics and disease patterns are challenging health and care systems across the world. In England, national policies have reset the direction of travel for the NHS. Collaboration, integration and personalisation are intended to become prime principles and drivers for new models of care. Central to this is the concept of population health management. This has emerged, internationally, as a method to improve population health. Fundamental for population health management to succeed is the use of integrated data, analytics combined with professional insight and the adoption of a learning health system culture. This agenda reaches beyond the NHS in England and the public health profession to embrace a broad range of stakeholders. By drawing on international experience and early experience of implementation in the United Kingdom, the potential for health and care systems in England to become world leading in population health management is explored.

A viewpoint paper.

Population health management is a major change in the way health and care systems look at the challenges they are facing. It makes what is happening to individuals, across the continuum of care, the essence for insight and action. The NHS has the components for success and the potential to become world leading in delivery of population health management as part of its integrated care agenda.

This is the first viewpoint paper to set out how population health management contributes to the integrated care agenda in the NHS.

The concepts of population health management in both theory and practice have significant implications for improving health care quality and lowering costs. I discuss the importance of defining the perspective and populations for population health management. Lifestyle management strategies emphasize health risk reduction and prevention techniques as they target a relatively healthy population. Demand management approaches extend lifestyle management strategies by concentrating on consumer demand for medical care services. Disease management techniques typically focus on individuals with chronic conditions such as diabetes, congestive heart failure, or asthma. These programs offer targeted health and care management services to help coordinate the needs and care of individuals with those specific diseases. Catastrophic care management services extend the disease management approach to provide health management services for individuals with catastrophic illnesses or injuries. Disability management approaches are designed from an employer's perspective to improve worker productivity by focusing on strategies to reduce injuries, avoid illness, and better manage employee disability. Information technologies especially are important in developing and implementing each of the above population health management strategies. A conceptual model of population health management integrates the theory and the practice of population health management on both individual and organizational levels. Lastly, I discuss practical and research issues around developing and applying a population health management model in the U.S.

The purpose of this article is to share emerging evidence about the qualitative and economic benefits of integrating care, based on an innovative population‐based approach across a small region of Germany. The article aims to discuss the features that have similarities to the international discussion around managed care and accountable care, e.g. the use of a “gain share” model to incentivise all the main partners, and the quite unique approaches derived from a public health background. The operation of Gesundes Kinzigtal could be considered as a benchmark for the “Clinical commissioning groups” that are in development as a result of the Health and Social Care Act 2012 in the UK.

A regional health management company in cooperation with the physicians' network in the region and two health insurance providers has reorganized the delivery of care across all sectors towards improving the health of the population. The key features of the approach are summarised in the paper. Administrative and medical data obtained from the health insurance providers and from routine management monitoring are used to evaluate the benefits of the approach compared to control groups.

The project is beginning to demonstrate that this model of integrated care can be effective, with cost benefits and savings for the partners, and improved health outcomes for the population.

The project started in 2006, and only early results of the first three to four years are reported here because of the use of claims data of health insurers.

The approach is an innovative model of integration in its combination of logistical re‐engineering of care processes, IT integration, public health and prevention measures. Its evaluation through an ambitious series of studies may have long‐term relevance for the organisation and management of care services internationally.

The purpose of this paper is to consider how the evolving concept of the “primary care home” (PCH) that is developing in England might be an effective vehicle for the delivery of the goals of “population health”. The authors examine evidence from earlier initiatives to achieve similar objectives of primary care-led health system planning and care integration to understand relevant lessons for the PCH.

This paper is based on a descriptive review of the PCH using documentary sources and a non-systematic review of literature relating to primary care commissioning initiatives and recent initiatives to deliver general practice services on a larger scale.

The PCH is likely to bring forth relatively high engagement from general practitioners due to its neighbourhood scale, voluntary nature and its focus on professional partnership, personalisation of care and outcomes. It is important that participants have sufficient autonomy to act and that financial incentives are aligned with the goals of population health. It is also important that, unlike some earlier primary care initiatives, the PCH is given time to develop to maturity.

The PCH is a recent phenomenon that is developing in England and elsewhere. This paper locates the PCH within a historical context and draws conclusions from a relevant evidence base.

Individuals suffering from serious mental illness (SMI) face many challenges of navigating a complex and often fragmented health care system and may die significantly earlier from co-morbid physical health conditions. Integrating mental and physical health care for individuals with SMI is an emerging trend addressing the often-neglected physical health care needs of this population to better coordinate care and improve health outcomes.

Population Health Management (PHM) provides a useful framework for designing integrated care programs for individuals with SMI.

This paper examines the structure and evolution of the integrated care program in Missouri in the context of PHM, highlighting particular elements of PHM that facilitate and support development of an integrated mental and physical health care program.

As health care reform provides external motivation to provide integrated care, this study can be useful as other states attempt to address this important issue.

Population, community, and public health notions are addressed separately in the Patient Protection and Affordable Care Act (ACA), have different foci and stakeholders, build on different frameworks to achieve their aims, and apply different measures to determine the long-term impact of interventions. This paper attempts to clarify each concept and proposes a method of evaluating each of these sets of health-related activities based on the benefits that accrue to the respective stakeholders.

In addition to indicating how to affect change and improvements in health, the ecological model of health also provides insight into how the benefits from health-related activities may or may not flow back to the entities sponsoring health interventions. By clearly defining each of the concepts and examining the methods and metrics being used to select activities and measure benefits, a valuation model is developed that measures the financial impact on the targeted population as well as the sponsoring institution.

Defining, measuring, and evaluating are important to bring clarity to how individual organizations can contribute to the overall health of the population, as well as the limits of any single organization in doing so. Collective and upstream action will be required to improve the population’s health, but identifying and justifying the role of each participating organization is a challenge that still lacks an overarching vision that can be explained and measured to the satisfaction of all stakeholders.

Decision makers must justify how resources are committed in an era of scarcity and limited financial means. Moreover, methods must be in place to measure the impact of potential collaborations. The proposed valuation framework lays out the natural incentives, the responses to those incentives, and how to select initiatives that maximize value from the perspective of the various stakeholders.

A range of strategies to improve pharmaceutical care has been implemented by population health management (PHM) initiatives. However, which strategies generate the desired outcomes is largely unknown. The purpose of this paper is to identify guiding principles underlying collaborative strategies to improve pharmaceutical care and the contextual factors and mechanisms through which these principles operate.

The evaluation was informed by a realist methodology examining the links between PHM strategies, their outcomes and the contexts and mechanisms by which these strategies operate. Guiding principles were identified by grouping context-specific strategies with specific outcomes.

In total, ten guiding principles were identified: create agreement and commitment based on a long-term vision; foster cooperation and representation at the board level; use layered governance structures; create awareness at all levels; enable interpersonal links at all levels; create learning environments; organize shared responsibility; adjust financial strategies to market contexts; organize mutual gains; and align regional agreements with national policies and regulations. Contextual factors such as shared savings influenced the effectiveness of the guiding principles. Mechanisms by which these guiding principles operate were, for instance, fostering trust and creating a shared sense of the problem.

The guiding principles highlight how collaboration can be stimulated to improve pharmaceutical care while taking into account local constraints and possibilities. The interdependency of these principles necessitates effectuating them together in order to realize the best possible improvements and outcomes.

This is the first study using a realist approach to understand the guiding principles underlying collaboration to improve pharmaceutical care.