For decades, healthcare spending in the United States has not been sustainable. Even before COVID-19, healthcare costs were rising at an alarming rate, consuming a huge chunk of the country’s national income. In 2021, the U.S. spent $4.3 trillion (18% of its GDP) on healthcare.
As the burden of chronic diseases and other health risks continues to rise, factors that bear the healthcare costs are increasingly shifting from individualized treatment to the population health model of care. The population health framework shifts the focus from isolated patient care to the broader health outcomes of entire communities defined by the Institute for Healthcare Improvement’s (IHI) Triple Aim:
- Improve the health of the entire population.
- Reduce the per capita cost of healthcare by reducing waste and eliminating error.
- Improve the individual experience of care (quality and satisfaction)
Today, population health management remains relevant as employers across all industries face many common challenges: higher healthcare costs, an aging workforce, and worker productivity issues due to numerous health issues. In this article, we’ll aim to define population health outcomes, explore examples of positive and negative outcomes and learn how to measure them.
Table of Contents
- What Are Examples of Population Health Outcomes?
- What Are Positive vs. Negative Population Health Outcomes?
- What Are the 3 Different Types of Population Health Outcomes?
- What Are Useful Measures of Population Health Outcomes?
- What Impacts Population Health Outcome Measures?
- Why Is Measuring Population Health Outcomes Important?
- What Are 8 Population Health Outcomes To Aim for at Your Company?
- How Do You Measure Population Health Outcomes at Your Company?
- What Are Actionable Steps To Set up a Measurement Framework at Your Organization?
- Conclusion
What is Population Health?
According to the New York State Department of Health, the definition of population health is “the health status and health outcomes within a group of people rather than considering the health of one person at a time.”
At its core, population health aims to improve the overall quality of life through a three-pronged approach:
- Reducing illness or disability by reducing disease risk
- Preventing new cases of illness
- Ensuring access to appropriate services for those with existing conditions
To achieve that, population health takes into account not only the physical health of individuals but also their social and economic well-being. It goes beyond clinical interventions and focuses on upstream causes, including education, poverty reduction, employment opportunities, affordable housing, insurance coverage, access to healthy food, etc.
What Are Examples of Population Health Outcomes?
Reduction in smoking-related mortality
Longer durations of smoking cessation are associated with progressively lower mortality rates from tobacco-induced diseases like Congestive Obstructive Pulmonary Disease (COPD) and lung cancer. Anti-smoking campaigns and smoking cessation programs in the workplace can decrease smoking rates. These efforts have improved respiratory health and reduced rates of smoking-related illnesses and deaths.
Decrease in obesity rates
Medical costs for adults with obesity are $1,861 higher than medical costs for people with a healthy weight. Obesity and overweight also contribute to 44% of the diabetes burden, between 7 and 41% of some cancers, and 23% of heart disease.
Improved mental health
Mental health is one of today’s biggest population health issues. Depression alone costs American employers $187.8 billion every year. Untreated depression is also a harbinger of other unpleasant issues like legal costs, disability, employee disengagement, and turnover. Raising mental health awareness, promoting early intervention, and increasing access to mental health services can improve overall health outcomes in your organization.
Increased life expectancy
The average American’s life expectancy at birth is 77 years. Various population health interventions like disease prevention and improving the social determinants of health can contribute to an even greater increase in life expectancy. This can lead to increased employee engagement and productivity and a seamless transfer of skills.
Reduction in health disparities
Health disparities are “differences that exist among specific population groups in the United States in the attainment of full health potential that can be measured by differences in incidence, prevalence, mortality, the burden of disease, and other adverse health conditions.” The American economy is projected to grow by $8 trillion by 2050 if the country addresses healthcare disparities.
What Are the 3 Different Types of Population Health Outcomes?
According to R. Gibson Parrish, MD, “An ideal population health outcome metric should reflect a population’s dynamic state of physical, mental, and social well-being.” This means simply aggregating individual health outcomes is not enough. Instead, population health outcomes are grouped into three overarching categories with various indicators that provide a high-level view of the various aspects of population health. These are:
- Mortality outcomes: These are indicators related to the death and survival rates within the population. They help identify patterns of premature death and population-level health disparities
- Morbidity outcomes: This set focuses on the incidence and prevalence of diseases, conditions, and disabilities within a population. These outcomes offer insights into the disease burden and a population’s overall health status
- Health-related quality of life (HRQoL) outcomes: These indicators capture the impact of health on individuals’ overall well-being, including physical, mental, and social aspects. These outcomes help identify areas where health interventions can improve the quality of life for individuals and communities.
What Are Useful Measures of Population Health Outcomes?
Measures of population health outcomes are specific indicators or metrics used to assess each type of population health outcome. They are the concrete, quantifiable data points that provide insights into different aspects of population health. Here are examples of each kind of outcome:
Mortality Rates
Mortality refers to the “number of deaths that occur in a population during a period of time (usually 1 year) divided by the size of the population.”
However, the mortality rate can be adjusted for a specific characteristic to give a clearer picture. For example, Age-adjusted mortality rates (AAMR) are used to compare mortality rates across different populations while accounting for variations in age distribution.
Other measures of mortality include sex-specific, race-specific, disease-specific, injury-specific, and even occupational class-specific mortality rates.
Life Expectancy
Life expectancy at birth is expressed as a person’s average longevity if the prevailing death rates at the time of birth for the specific year of birth do not change.
The World Health Organization (WHO) defines healthy life expectancy as the “Average number of years that a person can expect to live in “full health” by taking into account years lived in less than full health due to disease and/or injury.”
Prevalence of Chronic Conditions
90% of U.S. healthcare spending is spent on treating and managing chronic and mental health conditions. Furthermore, most deaths in the country are attributable to chronic disease.
Understanding the proportion of people in a population with a specific chronic illness, such as diabetes or hypertension, is crucial to the fight against these conditions.
Self-Reported Health Outcome Metrics
According to Parrish, “Societies and their members typically value health both subjectively (freedom from pain and suffering, joy, happiness, sense of self-worth and value to others) and objectively (ability to perform physical, mental, and social tasks).
The Centers for Disease Control and Prevention (CDC) refers to that as Health-related quality of life (HRQOL) and defines it as “an individual’s or a group’s perceived physical and mental health over time.”
The CDC uses the “Healthy Days Measures” questionnaire to determine the HRQOL. The questionnaire has four questions:
- Would you say that, in general, your health is excellent, very good, good, fair, or poor?
- Now thinking about your physical health, which includes physical illness and injury, how many days during the past 30 days was your physical health not good?
- Now thinking about your mental health, which includes stress, depression, and problems with emotions, how many days during the past 30 days was your mental health not good?
- During the past 30 days, approximately how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation?
Summary Measures of Population Health
These are alternatives to the mortality and life expectancy measures. Summary measures “combine information on mortality and nonfatal health outcomes to represent the health of a particular population as a single numerical index.” They include:
- Health-adjusted life expectancy – the number of years in full health that an individual can expect to live given the current morbidity and mortality conditions.
- Disability-free life expectancy – the average number of years a person aged ‘x’ would live with no limiting long-term illness if they experienced the particular area’s age-specific mortality and health rates throughout their life.
- Disability-adjusted life years – the sum of the years of life lost due to premature mortality (YLLs) and the years lived with a disability (YLDs) due to prevalent cases of the disease or health condition in a population.
- Quality-adjusted life years measure the value and benefit of health outcomes.
Why Is Measuring Population Health Important?
All businesses have the same overarching goals: to maximize productivity, reduce costs, and create a thriving work environment for employees. Measuring population health outcomes are important because it can contribute significantly to productivity, targeted interventions, cost savings, attracting and retaining talent, and measuring the effectiveness of interventions.
- Productivity: It’s often said that health is wealth. This is true both at the individual and the population level. A healthier workforce often increases productivity, as employees are less likely to be absent or experience presenteeism due to health issues.
- Targeted interventions: Population health outcomes data provides valuable insights into employee health status and helps identify health disparities among different groups. This, in turn, enables the stakeholders to identify areas for improvement and develop targeted interventions. Ultimately this leads to a healthier, more productive workforce and fosters a positive work environment that improves the corporate culture.
- Cost savings: A sick workforce increases healthcare costs and insurance premiums. Poor health also increases costs associated with absenteeism, turnover, and productivity losses.
- Attracting and retaining talent: Rising healthcare costs, the COVID-19 pandemic, and an uncertain economy have all underscored the importance of healthcare coverage. In fact, a company that prioritizes employee health and well-being is more likely to have a competitive advantage in today’s talent market.
- Measuring effectiveness of interventions: Tracking health outcomes helps organizations understand what matters most to their employees and assess the effectiveness of their interventions against those needs. This can help save money spent on ineffective interventions and make necessary adjustments to maximize impact.
What Impacts Population Health Outcome Measures?
Measurement of outcomes is critical in population health management, but the process can be complex and multifaceted. To borrow from the National Academy of Medicine, an organization cannot learn what initiatives and programs work best without a strong measurement capability. They will also not know where to guide their resources and how to promote accountability in results.
Accurate and reliable measurement of health outcomes enables population health professionals and policymakers to identify health disparities, monitor trends, and evaluate the effectiveness of their efforts. The credibility and usefulness of these measurements depend on several factors:
Data Quality and Accuracy
Poor-quality data leads to poor-quality interventions. On the other hand, accurate and complete data enables a better understanding and interpretation of the health status of a population. This not only helps the patient make better population health decisions but also enables the organization to keep track of the costs over a given time period.
Risk Stratification
Achieving positive population health outcomes requires a deep understanding of each demographic’s risks, and that’s where risk stratification comes in.
Stratify data by demographics (e.g., age, gender, job role) to identify specific subpopulations within the workforce that may require targeted interventions or support.
Choose indicators that are relevant to employee health, well-being, and productivity. Examples include absenteeism, presenteeism, employee turnover, job satisfaction, medical history, and workplace stress levels. This will help you match the employee’s risk status with the proper intervention and help reduce expensive treatments.
Data Interoperability
Interoperability is “the ability of two or more information systems, applications and software to exchange health information and use the information once it is received.” This enables comprehensive analysis, informed decision-making, and enhanced collaboration between stakeholders.
Adopting and optimizing electronic health records (EHRs) and health information exchange (HIE) services is one way of achieving interoperability. Others include collaborating with stakeholders and implementing robust data governance policies.
Level of Analysis
This describes the granularity or specificity at which health outcomes are measured and assessed. In a corporate setting, that can range from individual employees to larger groups, such as departments, job roles, or the entire organization. Selecting the appropriate level of analysis is essential to identify patterns, trends, and disparities in health outcomes.
Time Interval
This pillar refers to the frequency and duration at which health outcomes are measured and monitored. This can be short-term (e.g., monthly or quarterly) or long-term (e.g., annually or biennially). The choice of time interval depends on the nature of the health outcome being measured and the organization’s goals.
Regularly monitoring health outcomes over appropriate time intervals helps evaluate the effectiveness of interventions and make timely adjustments to health policies, programs, and initiatives. This ensures continuous improvement and alignment with the organization’s objectives.
8 Population Health Outcome Strategies
To support the overall well-being of your employees and improve company performance, it’s essential to establish clear and measurable population health outcomes. These can then serve as a foundation for developing effective wellness and population health initiatives that will drive organizational success. Here are 8 measurable population health outcomes your company can aim for:
- Reduced absenteeism and presenteeism
- Improved workplace safety
- Enhanced mental well-being
- Improved health-related quality of life
- Reduced occurrences of chronic conditions
- Lower sickness-related turnover rate
- Timely access to healthcare services
- Increased participation in wellness programs
Reduced absenteeism and presenteeism
Personal illness accounts for over 33% of unscheduled absences. Employees can also come to work sick and underperform, which still affects overall productivity and organizational performance. That’s presenteeism. The corporate goal should be to decrease the frequency of employee absences and presenteeism due to illness or health-related issues within a given period.
Improved workplace safety
Workplace accidents, injuries, and near-miss incidents cost employers millions in workers’ compensation and medical costs. Employers also risk incurring hefty OSHA penalties and recruitment costs to replace employees. Every organization should aim to reduce the number and severity of workplace accidents or injuries by implementing safety measures and promoting a culture of safety.
Enhanced mental well-being
The effects of poor emotional health are well documented. Depression alone costs American employers US$ 1 trillion annually, primarily through lost productivity. Improved self-reported mental health, stress levels, and overall emotional well-being among employees can positively impact job satisfaction and boost productivity.
Improved health-related quality of life
The average office worker spends more than a third of their day working. With digitization and increased tech adoption, most of this time is spent behind a desk, leading to low health-enhancing physical activity (HEPA) levels. Wellness programs targeting enhanced physical well-being among employees can increase job satisfaction and overall happiness.
Reduced occurrences of chronic conditions
Chronic illness accounts for over 67% of all deaths in the United States. A workplace chronic disease management program can help reduce the rates of chronic conditions like obesity, diabetes, and hypertension among employees. These conditions may start off non-fatal. However, they invariably lead to greater life-threatening complications like cardiovascular disease, stroke, etc. “Treatment of the seven most common chronic diseases, coupled with productivity losses, will cost the U.S. economy $2 trillion dollars annually – $8,600 per person – by 2030.” – National Association of Chronic Disease Directors.
Lower sickness-related turnover rate
Poor self-reported general health and an unhealthy workplace are leading causes of employee turnover. Reducing employee turnover related to health issues can increase retention, leading to greater organizational stability and performance.
Timely access to healthcare services
Every population has different cohorts that demand distinct management approaches. Strive to improve timely access to healthcare services such as preventive care, specialist consultations, and emergency department visits to ensure employees receive appropriate care when needed.
Increased participation in wellness programs
Medical care often accounts for only 10-20% of an individual’s overall health. The remaining percentage is attributed to the social determinants of health and individual behaviors. To balance these factors, encourage employee participation in company-sponsored health initiatives, such as fitness classes, stress management workshops, or smoking cessation support. This will help them stay healthy and ultimately reduce healthcare expenses for both employees and the organization.
How to Measure Population Health Outcomes
Measuring the population health outcomes at the organizational level is slightly different from what happens at the county, national or global level. However, it all boils down to data collection and the selection of indicators. Data about your population’s health can be measured from:
- Employee surveys: Carry out periodic surveys to collect self-reported data on health behaviors, mental wellness, and job satisfaction among employees.
- Monitoring absences and presenteeism: Keep track of sickness-related absences and occurrences of presenteeism, where staff members come to work despite being unwell.
- Records of workplace accidents: Document the frequency and severity of workplace accidents or injuries to evaluate the safety level of the work setting.
- Program participation rates: Measure employee engagement in company-sponsored wellness programs, such as fitness classes, stress management workshops, or smoking cessation support.
- Voluntary health evaluations: Offer voluntary health screenings to employees. These might include biometric screenings, blood pressure checks, or cholesterol tests, and track the outcomes over time.
- Insurance claims data: Analyze health insurance claims data to identify patterns related to healthcare utilization and the prevalence of specific health conditions among employees.
- Key performance indicators: Examine productivity metrics like output, performance reviews, or project completion rates. Determine the potential influence of employee health on job performance.
- Turnover rates: Track employee turnover and exit interview data to identify possible links between health and job satisfaction or retention.
- External partnerships: Collaborate with healthcare providers, wellness program vendors, or insurance companies to gather additional data and insights on employee health outcomes.
What Are Actionable Steps To Set up a Measurement Framework at Your Organization?
Establishing a robust measurement framework generally involves these steps below. Depending on your company’s needs and resources, you may even want to consider implementing population health informatics.
- Set clear goals: Outline your organization’s specific population health improvement goals. Focus on aspects like employee wellness, productivity, safety, and satisfaction.
- Choose relevant measures: Pick health outcome indicators that align with your goals. These indicators can include absenteeism, presenteeism, workplace accidents, involvement in wellness programs, and employee turnover rates.
- Establish data sources: Decide on the best methods for gathering data on the selected metrics. Will you use staff surveys, health assessments, insurance claim analysis, or tracking productivity indicators?
- Implement data collection tools: Utilize tools and software to facilitate data collection and storage. Ensure the quality and consistency of data is not compromised.
- Analyze and interpret data: Regularly review the collected data and identify trends and patterns. Present reports to stakeholders in your organization to promote transparency and showcase the impact of existing initiatives.
- Use data to inform decision-making: Apply insights from the data analysis to develop and implement health policies and interventions. Engage key stakeholders such as employees, management, and healthcare providers to ensure their support in implementation.
- Continuously improve: Evaluate the effectiveness of the measurement framework and make adjustments as needed.
Conclusion
Improving population health is a game-changer for organizations seeking to cultivate a vibrant, energetic, and productive workplace. From reducing healthcare costs and improving employee well-being to recruitment and retention, population health improvement has a lot of benefits. By embracing a holistic measurement framework and harnessing the power of data, your organization can uncover hidden opportunities, assess the impact of health initiatives, and fine-tune its approach for a lasting positive effect on its employees’ well-being.
