How can a health plan work proactively to improve the health of its members? First, it needs a baseline. Authors from HealthPartners, the Minnesota-based, consumer-governed, integrated healthcare organization, describe in a study published in the April issue of The American Journal of Managed Care (AJMC) how the nonprofit organization was unable to find a set of measurements that would allow it to improve its population health performance, so it created its own.
The measures reveal that musculoskeletal, psychosocial, and neurologic conditions have the greatest impact on members current health and eating a healthier diet is the greatest opportunity to improve future health.
The article, The Health and Well-being of an ACO Population, describes how HealthPartners created a measure of health and well-being from three scores: a current health score, a future health score, and a well-being score. The researchers calculated the current health score from insurance claims and death records for 754,584 members 18 years and older; it is the complement of disability-adjusted life-years (DALYs) and is composed of the disease burden due to mortality before age 75 years and morbidity.
They then surveyed members about their future health and well-being. The future health score has two parts; one is based on six member-reported behaviors, and the other is an age- and sex-specific preventive services score that is based on the performance of the medical group to which the health plan attributes the member.
The well-being score is based on a single validated question: How satisfied are you with your life?
Although 42% of the members reported a high level of well-being, 14% reported a low level of well-being. Members who were insured by Medicaid (which was used as a proxy for income) or who had low levels of education reported the lowest levels of well-being.
A total of 44% of the loss to the current health score was due to musculoskeletal, psychosocial, and neurologic conditions: lower back pain and cervical spine pain; anxiety and depression; and headache, migraine, and head injury, respectively.
In addition, the researchers found that increasing healthy eating is the greatest opportunity to improve the future health score.
The organization used a cross-sectional analysis of insurance claims, death records, and survey data to create the summary measure because relying on available data would not have provided this information. Using the findings to improve future health could have huge impacts. For instance, the researchers calculated that a 1-point increase in the mean future health score could be associated with a 5.6% reduction in DALYs.
The authors write that HealthPartners measures could help guide national efforts to improve population health and well-being, and they invite other organizations to test the validity and reliability of its methodology.
For the full study, click here.
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