Hospitals and health systems are evolving to navigate the changing health care landscape. The notion of an institution that is focused only on admitting, treating and discharging sick patients is fading.
Hospitals and health systems have always included health in measuring mission success, but now health will also be a common measure of business success. How is health created knowing that health care accounts for only ten percent of the overall health of populations (McGinnis et al, 2002)? Hospitals and health care systems can, and in the future will need to, extend beyond the ten percent of determinants impacted by health care to influence and measure other determinants of health for individuals and populations.
Children’s hospitals, with their expertise, the timing of their early life interventions, and reliability of their brand, can potentially impact the health of entire generations.
Investing in innovative children’s health approaches will create healthy families, communities and populations, and reduce future financial burden on the health care system. Historically, children’s hospitals’ interventions have occurred when symptoms present.
Anticipating, avoiding and preventing the onset of illness is a relatively new paradigm and will require ingenuity and collaboration beyond the health care system. This work impacts all children’s hospitals, and the Children’s Hospital Association recognizes a necessary and broad continuum of investment in creating health.
In fall 2014, Association staff worked in collaboration with members to gather information on national activities related to population health and member needs. Through this effort, staff involved 15 percent of the membership through site visits, phone interviews and focus groups to inform and help shape the forthcoming work.
Creating health and delivering health care are interdependent. Acute and chronic care delivery and population health have become linked in this new business model.
- Managing the health of populations challenges hospitals in current reimbursement models, but increasingly prepares providers and communities to assume risk.
- Whether children’s hospitals act as leaders or engaged partners, they are one of many needed to achieve population health.
- Tremendous diversity exists in the engagement levels of children’s hospitals in population health, based on local markets, resources and priorities.
- To improve the health of populations and communities, children’s hospitals are extending their focus beyond determinants impacted by health care to include the social determinants of health, for example, education, family/social support, community safety and housing.
- Addressing social determinants of health requires a “new” level of infrastructure and appropriate community engagement to have a desired impact on health – medically and socially.
This shift to a focus on population health redefines for the Association what has been a legacy commitment to child advocacy and the health and well-being of children, taking into account the evolving health care landscape.
A revised portfolio of collaborative initiatives will be developed to equip member hospitals to lead and/or contribute to the health of their communities. Through this work, we intend to:
- Articulate the role and opportunity of children’s hospitals and health systems in partnership with their communities to be agents in creating health for children and families.
- Build children’s hospitals’ capabilities along the continuum of population health.
- Foster alignment of current and future Association activities in population health and the transformation of care delivery work underway.