HOW MODELING CAN
INFORM STRATEGIES
to IMPROVE
POPULATION HEALTH
WORKSHOP SUMMARY
Joe Alper and Amy Geller, Rapporteurs
Roundtable on Population Health Improvement
Board on Population Health and Public Health Practice
Institute of Medicine
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This activity was supported by contracts between the National Academy of Sciences and the Aetna Foundation (#10001504), The California Endowment (20112338), HealthPartners, Kaiser East Bay Community Foundation (20131471), The Kresge Foundation (101288), Mayo Clinic, Missouri Foundation for Health (12-0879-SOF-12), Nemours, New York State Health Foundation (12-01708), Novo Nordisk, and the Robert Wood Johnson Foundation (70555). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-37848-2
International Standard Book Number-10: 0-309-37848-6
Digital Object Identifier: 10.17226/21807
Additional copies of this workshop summary are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.
Copyright 2016 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2016. How modeling can inform strategies to improve population health: Workshop summary. Washington, DC: The National Academies Press. doi: 10.17226/21807.
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PLANNING COMMITTEE FOR HOW MODELING CAN INFORM STRATEGIES TO IMPROVE POPULATION HEALTH1
STEVEN TEUTSCH (Chair), Former Chief Science Officer, Los Angeles County Public Health
ANA DIEZ ROUX, Dean, Drexel University School of Public Health
MARTHE GOLD, Visiting Scholar, New York Academy of Medicine; Professor Emerita of Community Health and Social Medicine, City College of New York
DAVID MENDEZ, Associate Professor of Health Management and Policy, Department of Health Management and Policy, University of Michigan School of Public Health
BOBBY MILSTEIN, Director, ReThink Health
PASKY PASCUAL, Former Director, Council for Regulatory Environmental Modeling, Environmental Protection Agency
LOUISE RUSSELL, Distinguished Professor, Institute for Health, Health Care Policy and Aging Research and Department of Economics, Rutgers University
STEVEN WOOLF, Director, Virginia Commonwealth University Center on Society and Health
___________________
1Institute 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.
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ROUNDTABLE ON POPULATION HEALTH IMPROVEMENT1
GEORGE ISHAM (Co-Chair), Senior Advisor, HealthPartners, Inc., and Senior Fellow, HealthPartners Institute for Education and Research
DAVID A. KINDIG (Co-Chair), Professor Emeritus and Emeritus Vice Chancellor, 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 Board of Health
CATHERINE BAASE, Global Director of Health Services, The Dow Chemical Company
GILLIAN BARCLAY, Vice President, Aetna Foundation
RAYMOND J. BAXTER, Senior Vice President, Community Benefit, Research and Health Policy, Kaiser Permanente and President, Kaiser Permanente International
RAPHAEL BOSTIC, Judith and John Bedrosian Chair in Governance and Public Enterprise, Sol Price School of Public Policy, University of Southern California
DEBBIE I. CHANG, Vice President, Policy and Prevention, Nemours
CARL COHN, Clinical Professor of Education, Claremont Graduate University
CHARLES FAZIO, Medical Director, HealthPartners, Inc.
GEORGE R. FLORES, Program Manager, The California Endowment
JACQUELINE MARTINEZ GARCEL, Vice-President, New York State Health Foundation
ALAN GILBERT, Director, Global Government and NGO Strategy, healthymagination
MARY LOU GOEKE, Executive Director, United Way of Santa Cruz County
MARTHE R. GOLD, Emeritus Professor, Sophie Davis School of Biomedical Education, City College of New York
GARTH GRAHAM, President, Aetna Foundation
ROBERT HUGHES, President and Chief Executive Officer, Missouri Foundation for Health
ROBERT M. KAPLAN, Chief Science Officer, Agency for Healthcare Research and Quality
JAMES KNICKMAN, President and Chief Executive Officer, New York State Health Foundation
___________________
1Institute 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.
PAULA LANTZ, Professor and Associate Dean for Research and Policy Engagement, Gerald R. Ford School of Public Policy, University of Michigan
MICHELLE LARKIN, Assistant Vice President, Health Group, Robert Wood Johnson Foundation
THOMAS A. LaVEIST, William C. and Nancy F. Richardson Professor in Health Policy and Director, Hopkins Center 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
SANNE MAGNAN, President and Chief Executive Officer, Institute for Clinical Systems Improvement
PHYLLIS D. MEADOWS, Associate Dean for Practice, Office of Public Health Practice, School of Public Health, University of Michigan, and Senior Fellow, Health Program, The Kresge Foundation
BOBBY MILSTEIN, Director, ReThink Health
JUDITH A. MONROE, Director, Office for State, Tribal, Local, and Territorial Support, Centers for Disease Control and Prevention
JOSÉ MONTERO, Vice President of Population Health and Health Systems Integration, Cheshire Medical Center/Dartmouth Hitchcock Keene
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
MARTÍN JOSE SEPÚLVEDA, Fellow and Vice President, Health Industries Research, IBM Corporation
ANDREW WEBBER, Chief Executive Officer, Maine Health Management Coalition
IOM Staff
ALINA BACIU, Roundtable Director
AMY GELLER, Senior Program Officer
LYLA HERNANDEZ, Senior Program Officer
COLIN FINK, Senior Program Assistant
ANDREW LEMERISE, Research Associate
DARLA THOMPSON, Associate Program Officer
ROSE MARIE MARTINEZ, Senior Board Director, Board on Population Health and Public Health Practice
Consultant
JOE ALPER, Rapporteur
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Reviewers
This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. 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:
Sandro Galea, Boston University
Trina Gonzalez, Milbank Memorial Fund
Tiffany Huang, National Association of County and City Health Officials
Tamar Lansky, MIE Resources
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 Ned Calonge, The Colorado Trust. He 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 rapporteurs and the institution.
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Acknowledgments
The sponsors of the Roundtable on Population Health Improvement have made it possible to plan and conduct the workshop How Modeling Can Inform Strategies to Improve Population Health, which this report summarizes. Non-federal sponsorship was provided by the Aetna Foundation, The California Endowment, HealthPartners, Kaiser East Bay Community Foundation, The Kresge Foundation, Mayo Clinic, Missouri Foundation for Health, Nemours, New York State Health Foundation, Novo Nordisk, and the Robert Wood Johnson Foundation.
The Roundtable wishes to express its appreciation to the following speakers and moderators at the workshop for their interesting and stimulating presentations: Rajiv Bhatia, Sharon Cooper, Ross Hammond, J. T. Lane, Nick Macchione, David Mendez, George Miller, Bobby Milstein, Karen Minyard, Pasky Pascual, Louise B. Russell, Darshak Sanghavi, Steven Teutsch, Gary VanLandingham, Michael Weisberg, and Steven Woolf.
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Contents
Organization of the Workshop Summary
Why Modeling Matters for Improving Population Health
3 CASE STUDIES OF MODELS USED TO INFORM HEALTH POLICY
Computational Models in Tobacco Policy
Defending Public Health Models in the Courtroom
Modeling Regional Health Reform Using the Rethink Health Dynamics Model
4 WHAT WOULD PUBLIC HEALTH DECISION MAKERS LIKE FROM MODELS?
Modeling Evidence-Based Programs in Multiple Policy Areas
5 BARRIERS AND OPPORTUNITIES FOR USING MODELS TO INFORM POPULATION HEALTH INTERVENTIONS AND POLICIES
Model Validation and Decision Making
Improving Communication with Policy Makers on the Use and Usefulness of Models
6 OPPORTUNITIES FOR THE FUTURE
Opportunities in Prevention and Population Health Care Modeling
Lessons from Models for Population Health
Boxes, Figures, and Tables
BOXES
2-1 Points Highlighted by the Individual Speakers
3-1 Points Highlighted by the Individual Speakers
4-1 Points Highlighted by the Individual Speakers
5-1 Points Highlighted by the Individual Speakers
6-1 Points Highlighted by the Individual Speakers
FIGURES
2-1 Framework describing the health factors used to determine county health rankings
3-1 The basic aggregate model used to track the fate of smokers
3-2 Observed versus predicted smoking prevalence, all ages
3-3 Observed versus predicted adult smoking prevalence in the United States
3-4 Forecasted overall smoking prevalence by different peak prevalence at age 18
3-5 Compartment model of smoking prevalence and health effects
3-8 Initiative options in the ReThink Health model
3-9 Downstream investments in high-value care produce relatively fast, focused impacts that plateau
3-11 Spending and yield—the per capita change versus baseline in health care and program costs
4-1 Value-per-effort graph for model creation
6-1 Pedometer data from a 4-year-old at DisneyWorld (above) and at day care (below)
6-3 Air pollution health risks in San Francisco
6-4 Minimum wage health impacts
TABLES
4-1 Cost–Benefit Analysis for Community-Based Functional Family Therapy
4-2 Cost–Benefit Analysis on a Portfolio of Programs Aimed at Juvenile Offenders
Acronyms and Abbreviations
| ADHD | attention deficit/hyperactivity disorder |
| CDC | Centers for Disease Control and Prevention |
| CMMI | Center for Medicare & Medicaid Innovation |
| CMS | Centers for Medicare & Medicaid Services |
| EPA | Environmental Protection Agency |
| FDA | Food and Drug Administration |
| HHS | Department of Health and Human Services |
| HIA | health impact assessment |
| IOM | Institute of Medicine |
| MCO | managed care organization |
| MIDAS | Models of Infectious Disease Agent Study |
| NIH | National Institutes of Health |
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