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Defining Population Health 

Population health is defined as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” Northeast Health Partners (NHP) will work to reduce the health disparities within the Health First Colorado (Colorado’s Medicaid Program) population.  Health disparities refer to the differences in access or availability of services and facilities.  NHP will utilize population health management tools which studies the distribution of health conditions and health-related behaviors to improve Members’ health.  NHP will also consider how social determinants of health, such as income, culture, race, age, family status, housing status, and education level impact Members’ health.

NHP has developed a Population Health Management Plan for both adult and pediatric Members. NHP will update the Population Health Management Plan with input from the local Program Improvement Advisory Committee (PIAC), community stakeholders, and other providers.

Our approach to Population Health Management encompasses eight key elements: 

  1. Focus on the health of populations
  2. Address the determinants of health and their interactions
  3. Base decisions on evidence
  4. Increase upstream investments 
  5. Apply multiple strategies 
  6. Collaborate across sectors and levels 
  7. Employ mechanisms for public involvement 
  8. Demonstrate accountability for health outcomes 

NHP will leverage technology such as text-based population health campaigns and tools that link Members with community resources.  NHP will ensure that PCPs and care coordinators are aware of these text-based campaigns to reinforce the messages that our Members receive.  Members who may need more intensive services or care coordination to improve their overall health and wellness will be referred to a Care Coordinator.

NHP will share results with the Department of Healthcare, Policy and Financing (HCPF), our community stakeholders, and the public.   These results will be shared through formal reporting to HCPF, trainings, community partnerships, success stories, the Member Advisory Council, and Regional PIAC.