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Managing population health
1University of Wisconsin School of Medicine, Madison, USA.
As experience with managing the health of populations is gained, resources will have to be set aside for rewarding improvements in Health Adjusted Life Expectancy (HALE). Financial incentives and rewards will need to be aligned with improved outcomes, instead of the traditional fee-for-service structure. This article describes how a uniform health outcomes measurement such as HALE could be incorporated by public and private purchasers of medical care and those responsible for the nonmedical determinants of health sectors and services. Three phases of potential development and implementation are outlined: (1) Phase One (1997-2000): Debate, acceptance, and, research; (2) Phase Two (2001-2010): Outcome-based payment for integrated health delivery systems; and (3) Phase Three (2011-2020): incorporating the non-medical determinants and sector.
As experience with managing the health of populations is gained, resources will have to be set aside for rewarding improvements in Health Adjusted Life Expectancy (HALE). Financial incentives and rewards will need to be aligned with improved outcomes, instead of the traditional fee-for-service structure. This article describes how a uniform health outcomes measurement such as HALE could be incorporated by public and private purchasers of medical care and those responsible for the nonmedical determinants of health sectors and services. Three phases of potential development and implementation are outlined: (1) Phase One (1997-2000): Debate, acceptance, and, research; (2) Phase Two (2001-2010): Outcome-based payment for integrated health delivery systems; and (3) Phase Three (2011-2020): incorporating the non-medical determinants and sector.
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