Opportunity Knocks: Population Health in State Innovation Models

Author: Auerbach J, Chang DI, Hester JA, Magnan S

In this discussion paper, the authors describe an emerging opportunity for reorienting the way we pay for health in the United States toward a greater focus on the non-clinical factors that make people healthy, such as the social and environmental conditions in places where people live, learn, play, and work. The Centers for Medicare & Medicaid Services State Innovation Models (SIMs) Initiative “is providing up to $300 million to support the development and testing of state-based models for multi-payer payment and health care delivery system transformation with the aim of improving health system performance for residents of participating states.” The authors describe this as a perfect opportunity to test and implement SIMs that dedicate a portion of their resources to pilots and experiments that focus on the third aim of improving population health. One starting point could be the adoption and use of population health metrics, such as the prevalence of risk factors (for example, obesity) and illness (for example, diabetes, HIV), and summary measures of population health, such as health-adjusted life-years.

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Auerbach J, Chang DI, Hester JA, Magnan S. Opportunity Knocks: Population Health in State Innovation Models. Washington, DC: Institute of Medicine. 2013 August 21.Available from: http://www.iom.edu/Global/Perspectives/2013/OpportunityKnocks.aspx.