Longitudinal Trends in Insurer Participation in Multisector Population Health Activities

Area of Science:

• Health Services Research
• Public Health Policy
• Health Insurance Management

Background:

• Healthcare organizations are expanding efforts to address social determinants of health (SDOH) to improve outcomes and reduce costs.
• Research has primarily focused on hospitals and physicians, with limited understanding of health insurers' roles in population health initiatives.
• Understanding health insurer engagement is crucial for comprehensive population health strategies.

Purpose of the Study:

• To examine trends in health insurer participation in population health activities and collaborative networks from 2006 to 2018.
• To assess the impact of Medicaid expansion on health insurer involvement in population health networks.
• To identify specific population health activities where insurers are most engaged.

Main Methods:

• Utilized data from the National Longitudinal Survey of Public Health Systems (2006-2018).
• Employed a difference-in-differences approach to analyze the effect of Medicaid expansion.
• Examined trends in insurer participation in population health activities and multi-sector networks.

Main Results:

• Health insurer participation in population health activities and networks significantly increased between 2006 and 2018.
• Insurers were most active in community health assessment and policy development.
• Medicaid expansion was associated with significant increases in insurer participation in assessment and policy/planning activities.

Conclusions:

• Health insurer engagement in population health is growing, particularly in assessment and policy.
• Medicaid expansion serves as a catalyst for greater insurer integration into population health networks.
• Policy mechanisms promoting insurance coverage can drive insurer involvement in broader population health efforts.