Frontiers of Health Services Management - Summer 2014 - (Page 9)

confusion as the clinical care system moves rather swiftly toward measuring the health of the subpopulations they serve. geopolitical areas rather than simply geographic areas are recommended when measuring total population health since funding decisions and regulations are inherently political in nature" (Jacobson and teutsch 2013). the ioM roundtable further observes that (ioM 2011a) at the current time there is variation in which concept or definition Triple Aim practices use. . . . [W]hile many embrace a population health or population medicine perspective, a few are striving towards a geographic regional emphasis moving towards a population health definition. Reaching Beyond Core Mission: A Healthcare Example D avid A. Kindig a nd Ge org e Is ha m * 9 f e a t u r e Stakeholders need to evaluate their capabilities and opportunities in order to form partnerships in addressing a broad array of health determinants. gaining experience within their own organization prepares stakeholders for eventual participation in fully established community partnerships based on the community health business model. one healthcare stakeholder serves as an example by engaging in population health improvement in an expanded way, going beyond its core mission of healthcare delivery and, in partnership with others, addresses additional determinants of health. HealthPartners, a 1.4 million member, consumer-governed, nonprofit integrated health system in Minnesota, began to discuss such partnerships during its 2010 formal strategic planning as goals and objectives were being established for 2014 (isham et al. 2013). through these initial preparations, the HealthPartners board of directors became aware that to achieve its mission-"to improve health and wellbeing in partnership with our members, patients and community"-much more than excellent clinical care would be required. Using the population health model from the University of Wisconsin (which estimates that clinical care contributes 20 percent of the total impact on health outcomes, health behaviors 30 percent, social and economic factors 40 percent, and the physical environment 10 percent; see exhibit 1), one of us (gi) worked with HealthPartners' staff and board members to define the relationship of various determinant categories to the organization's mission, existing capabilities, and degree of control over outcomes. the HealthPartners board understood that all four categories were important to its stated overall mission. However, its members recognized that HealthPartners' existing capabilities and degree of control were more robust in clinical care, it shared control with public health for health behaviors, and it had less robust capabilities and control compared to those of other actors for socioeconomic and environmental factors. it followed that HealthPartners would have to execute well in clinical care, partner effectively with public health in modifying health behaviors, and be an effective partner with other stakeholders in community efforts to address socioeconomic and environmental determinants of health. this paradigm was new territory for some HealthPartners board members; they observed during this process that "we are not the public health department" and we "can't be everything to everyone," and directed that HealthPartners "find our niche" given the organization's capabilities and priorities and find ways to partner

Table of Contents for the Digital Edition of Frontiers of Health Services Management - Summer 2014

Table of Contents

Frontiers of Health Services Management - Summer 2014