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NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
This activity was supported by contracts between the National Academy of Sciences and The California Endowment (20112338), the California HealthCare Foundation (17102), HealthPartners, Health Resources and Services Administration (HHSH25034015T), Kaiser East Bay Community Foundation (20131471), Kresge Foundation (101288), the Mayo Clinic, Missouri Foundation for Health (12-0879-SOF-12), the National Association of County and City Health Officials (2013-010204), Nemours, New York State Health Foundation (12-01708), Novo Nordisk, and the Robert Wood Johnson Foundation (70555). The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the activity.
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Suggested citation: IOM (Institute of Medicine). 2014. Population health implications of the Affordable Care Act: Workshop summary. Washington, DC: The National Academies Press.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council.
PLANNING COMMITTEE ON POPULATION HEALTH IMPLICATIONS OF THE AFFORDABLE CARE ACT1
GEORGE R. FLORES (Co-Chair), Program Manager, The California Endowment
DAVID KINDIG (Co-Chair), Professor Emeritus, University of Wisconsin School of Medicine and Public Health
DEBBIE I. CHANG, Vice President, Policy and Prevention, Nemours
DAVE CHOKSHI, White House Fellow, Department of Veterans Affairs
JEFFREY LEVI, Executive Director, Trust for America’s Health, and Assistant Professor, Department of Health Policy, George Washington University
JUDITH A. MONROE, Director, Office for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention
KAVITA PATEL, Fellow and Managing Director, Engelberg Center for Health Care Reform, The Brookings Institute
ANDREW S. REIN, Associate Director for Policy, Centers for Disease Control and Prevention
Consultant
JOE ALPER, Consulting Writer
IOM Staff
ALINA B. BACIU, Study Director
COLIN F. FINK, Senior Program Assistant
LYLA HERNANDEZ, Senior Program Officer
ANDREW LEMERISE, Research Associate
CAROL MASON SPICER, Associate Program Officer
ROSE MARIE MARTINEZ, Director, Board on Population Health and Public Health Practice
______________
1 Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution.
ROUNDTABLE ON POPULATION HEALTH IMPROVEMENT1
GEORGE ISHAM (Co-Chair), Senior Advisor, HealthPartners, and Senior Fellow, HealthPartners Institute for Education and Research
DAVID KINDIG (Co-Chair), Professor Emeritus, University of Wisconsin School of Medicine and Public Health
TERRY ALLAN, President, National Association of County and City Health Officials, and Health Commissioner, Cuyahoga County (Ohio) Board of Health
RAYMOND J. BAXTER, Senior Vice President, Community Benefit, Research and Health Policy, Kaiser Permanente, and President, Kaiser Foundation International
DEBBIE I. CHANG, Vice President, Policy and Prevention, Nemours
GEORGE R. FLORES, Program Manager, The California Endowment
MARY LOU GOEKE, Executive Director, United Way of Santa Cruz County, California
MARTHE R. GOLD, Visiting Scholar, New York Academy of Medicine, and Professor, Sophie Davis School of Biomedical Education, City College of New York
PEGGY A. HONORÉ, Director, Public Health System, Finance and Quality Program, Office of the Assistant Secretary for Health, Department of Health and Human Services
ROBERT HUGHES, President and Chief Executive Officer, Missouri Foundation for Health
ROBERT M. KAPLAN, Director, Office of Behavioral and Social Sciences Research, National Institutes of Health
JAMES KNICKMAN, President and Chief Executive Officer, New York State Health Foundation
PAULA LANTZ, Professor and Chair, Department of Health Policy, The George Washington University School of Public Health and Health Services
MICHELLE LARKIN, Assistant Vice President, Health Group, Robert Wood Johnson Foundation
THOMAS A. LAVEIST, Professor and Director, Hopkins for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health
JEFFREY LEVI, Executive Director, Trust for America’s Health
SARAH R. LINDE, Rear Admiral, U.S. Public Health Service, Chief Public Health Officer, Health Resources and Services Administration
______________
1 Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution.
SANNE MAGNAN, President and CEO, Institute for Clinical Systems Improvement
PHYLLIS D. MEADOWS, Senior Fellow, Health Program, Kresge Foundation, and Associate Dean for Practice, Office of Public Health Practice, School of Public Health, University of Michigan
JUDITH A. MONROE, Director, Office for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention
JOSÉ MONTERO, President, Association of State and Territorial Health Officials, and Director, New Hampshire Division of Public Health Services
MARY PITTMAN, President and Chief Executive Officer, Public Health Institute
PAMELA RUSSO, Senior Program Officer, Robert Wood Johnson Foundation
LILA J. FINNEY RUTTEN, Associate Scientific Director, Population Health Science Program, Department of Health Sciences Research, Mayo Clinic
BRIAN SAKURADA, Senior Director, Managed Markets and Integrated Health Systems, Novo Nordisk
MARTIN JOSÉ SEPÚLVEDA, IBM Fellow and Vice President, Health Systems Policy Research, IBM Corporation
ANDREW WEBBER, Chief Executive Officer, Maine Health Management Coalition
IOM Staff
ALINA B. BACIU, Study Director
COLIN F. FINK, Senior Program Assistant
LYLA HERNANDEZ, Senior Program Officer
ANDREW LEMERISE, Research Associate
CAROL MASON SPICER, Associate Program Officer
ROSE MARIE MARTINEZ, Director, Board on Population Health and Public Health Practice
Reviewers
This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:
Georges Benjamin, American Public Health Association
Lawrence Deyton, George Washington University
David Kindig, University of Wisconsin–Madison
Kate Papa, AcademyHealth
Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by Susan J. Curry, University of Iowa. Appointed by the Institute of Medicine, she was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the rapporteur and the institution.
Contents
A Nonprofit Model of Integration
All-Payer Hospital Payment Reform
State-Wide Health System Transformation
The Community Health Center Perspective
4 A PROPOSAL TO BRIDGE THE DIVIDE BETWEEN HEALTH AND HEALTH CARE
5 CATALYZING AND SUSTAINING THE ADOPTION AND INTEGRATION OF A POPULATION HEALTH CONCEPT
Perspectives from an Integrated Child Health System
The Role of Grassroots Leaders in Improving Community Health
| ABIA | Austen BioInnovation Institute in Akron |
| ACA | Affordable Care Act |
| ACC | accountable care community |
| ACO | accountable care organization |
| CCO | coordinated care organization |
| CCROPP | Central California Regional Obesity Program |
| CDC | Centers for Disease Control and Prevention |
| CHA | Catholic Health Association |
| CHNA | community health needs assessment |
| CHW | community health worker |
| CMS | Centers for Medicare & Medicaid Services |
| CPPW | Communities Putting Prevention to Work |
| EHR | electronic health record |
| HHSA | Health and Human Services Agency |
| IOM | Institute of Medicine |
| IRS | Internal Revenue Service |
| NACCHO | National Association of County and City Health Officials |
