The experience of Blue Cross and Blue Shield in the US offers lessons for the NHS about some of the ingredients needed to improve population health, according to Hugh Alderwick
Population health means different things to different people – a problem made worse by its growing popularity. In simple terms, population health refers to the health outcomes of a group of individuals, as well as how these outcomes are distributed within the group.
This means that improving population health is not just the job of health services, but requires coordinated efforts across different sectors and wider communities.
The experience of Blue Cross and Blue Shield in the US offers lessons for the NHS about some of the ingredients needed to improve population health. Nancy Mamo highlights two of these lessons in particular.
First is the importance of using individual and population level data to understand patterns of need, design effective interventions, and track health outcomes and use of services – as well as feeding these data back to clinicians and other professionals to support service changes. This kind of smart use of data is far from being the norm within the NHS, let alone between the NHS and other public services.
‘Underlying social, economic and environmental determinants of health across populations need attention’
Second is the role that new ways of paying for services can play in supporting population health improvement. In England, this will require pooling of budgets to enable resources to be used flexibly to meet population health needs – at least between health and social care services but potentially much further – matched with new approaches to paying for outcomes between different agencies to incentivise joint working on population health.
As well as learning lessons from successful healthcare systems like Blue Cross Blue Shield, the NHS needs to be careful not to fall into the trap of thinking about population health primarily in terms of patients, medical interventions and reducing healthcare costs.
Efforts to improve population health in England must also pay attention to the underlying social, economic and environmental determinants of health across populations, which too often get neglected.
Hugh Alderwick, senior policy assistant to the chief executive and integrated care programme manager, The King’s Fund