Population Health is defined as the health of a population as measured by health status indicators, and is influenced by a variety of social, economic, and physical factors. The Population Health (PH) Unit helps with coordinating projects for DMAS, focusing on population health trends and possible health care gaps, including maternal health, behavioral health, foster care, health equity, and social determinants of health. The PH Unit is responsible for identifying, collecting, carefully studying, and maintaining quality and population health data from managed care organizations (MCOs) and working with the Quality Improvement unit to provide feedback and recommendations on areas of opportunity for improvement.
Population Health Management (PHM) is the process of improving medicine-based health results of the whole population, by providing improved care coordination and member engagement by using effective care and managing money models. The MCOs review Population Health Management (PHM) for their members, and monitor and share the results with DMAS. According to the National Committee of Quality Assurance (NCQA), at a minimum PHM deals with the needs of the member by focusing on the following key areas:
- Keeping members safe
- Managing members with newly appearing high risks
- Monitoring patient safety or results across settings
- Managing multiple long-lasting illnesses
Overall, the Population Health (PH) Unit, using this data-driven approach to population health, works to advance DMAS’s mission to continue to improve the health of Virginians and make sure members receive access to high-quality care.