RISE 2017: Time for providers, payers to embrace 'community population health'

NASHVILLE, Tenn.—As it has moved from focusing solely on clinical care to embracing population health, the American healthcare system has already taken a step in the right direction, according to John Lumpkin, M.D., the senior vice president of the Robert Wood Johnson Foundation.

But, he argued during a keynote address at the 2017 RISE Summit, the industry must go even further by moving from “clinical population health” to the broader “community population health.”

This is vital because while the United States has some of the best clinical science in the world, it lags behind other industrialized countries when it comes to healthcare quality, outcomes and even life expectancy, according to Lumpkin. Thus, “we have to think about health and healthcare in a different way,” he said.

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To promote a move toward community population health, he advocated a four-pronged approach:

  • Build a culture of health. As an example, Lumpkin pointed out that one of the best steps to take to improve the health of a nation is to provide universal pre-Kindergarten education. That’s because it teaches students the social and emotional skills needed to have a better chance of graduating high school, which in turn ultimately correlates to better health.
  • Create cross-sector collaboration. Lumpkin highlighted a local effort called Nashville Health, which focuses on three local health challenges—hypertension, diabetes and tobacco use. The initiative not only involves health plans and providers, but also non-healthcare partners such as the city’s Chamber of Commerce and the Bank of America, and owes some of its success to having such a diverse array of stakeholders.
  • Create healthier and more equitable communities. Equity is paramount, he said, because “in many ways, your ZIP code says as much about your life expectancy as your genetic code.” To promote health equity, traditional providers can get involved—as the Robert Wood Johnson University hospital in New Brunswick, New Jersey, did when it built a grocery store to serve an area that had been a food desert, plus a fitness center and pool to serve the community.
  • Strengthen the integration of health and health systems. To exemplify this, Lumpkin highlighted a tool called Propeller, which helps patients become partners in their asthma treatment by measuring and reporting to providers how they use their inhalers. The data collected about inhaler use can also help pinpoint areas in a community with poor air quality, he added.

As another example, Lumpkin pointed to Cincinnati Children’s Hospital, which partnered with the legal community to take action when it learned that many children who wound up at the emergency room during a heat wave lived in buildings where the landlord would evict them for installing an air conditioner.

That’s an example of clinical population health, Lumpkin said, but the hospital also took it one step further by investing in the rehabilitation and development of one of the poorer neighborhoods in Cincinnati. That, he said, is community population health.

And “if we begin to work in that way, we are convinced that we as a nation will not only survive, but together we will begin to build a culture of health,” Lumpkin said.