8 | Background
to equity, social justice, and access to health care. A large number of Americans who previously had no health insurance for instance, will now have access to care. However, access to health care does not necessarily mean that the care delivered will be patient-centered, high-quality or equitable. Improving health for all depends on equality in access to care and care utilization that leads to high-quality health care, and addresses disparities among different populations, so that all populations have an opportunity to reach their full potential for good health.12,13,14 THE ROLE OF HEALTHCARE SYSTEMS The focus on population health represents a shift in the field of public health; understanding and managing it will become more and more integrated into the role of healthcare providers. Hospitals not only have to rely on demographic and clinical data to identify populations in greatest need, but also analyze those needs, prepare comprehensive reports, and leverage existing resources in attempts to reach and support community members.15 Limited resources should be used to focus on the most pressing needs with the biggest possible impact. Furthermore, because hospitals and healthcare systems have limited control and capabilities to address socioeconomic factors and physical environments, collaboration with community stakeholders is essential. The American Hospital Association encourages hospitals to adopt population health management strategies because with healthcare reform, it is imperative that stakeholders and community members work in partnership. Healthcare reform is driving healthcare systems and hospitals toward a new role of shared accountability in population health management to explore new methods of care delivery.16 PROVIDING POPULATION-BASED CARE Managing population health means having an effective, collaborative strategy for improving the health of all communities and reducing inequalities in health outcomes between different populations. However, promoting the good health of the community has to become more than just a mission statement. After analyzing the distribution of health outcomes in different populations, providers must find ways to improve the population’s health that are tailored to meet community needs while leveraging their assets. Hospitals and healthcare systems can ensure that they are promoting efficient care by: (1) increasing the prevalence of evidence-based prevention health services, (2) improving quality of patient care, and (3) enhancing care coordination.17 Currently, chronic conditions account for more than 75 percent of U.S. healthcare costs.18 One goal of population-based care has been described as moving from treating chronically-ill individuals to having a chronically-well population.19 Adventist HealthCare (AHC) is dedicated to achieving performance excellence, expanding access to care, and providing population-based care, all integral parts of the organization’s 2010–14 strategic plan. AHC hospitals and their boards have focused their strategic priorities to make population health a central theme, reallocate resources, and commit to changes. A population-based health approach recognizes that achieving positive health outcomes for everyone in our communities is a shared responsibility. Such collaborative efforts require partners to share responsibility and accountability for collecting data systematically or merging existing data, identifying factors that influence population health, measuring outcomes, and addressing determinants of health through policies and interventions. Partners include healthcare delivery systems, public health agencies, national and local entities, primary care entities, and community-level organizations as well as stakeholders in other, nonhealth sectors such as schools and businesses.
“Equity in access to health care implies that everyone has the opportunity to reach their full health potential; in short, the playing field is leveled for all individuals.”20