Population Health Funding and Accountability to Community: Proceedings of a Workshop (2023)
Chapter: 1 Introduction
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Introduction1
On June 22, 2022, the Roundtable on Population Health Improvement in the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine held a virtual workshop, Population Health Funding and Accountability to Community.
Roundtable co-chair Raymond Baxter, the vice chair of the board of trustees of the Blue Shield of California Foundation and the secretary of the board of the CDC Foundation, welcomed participants. Given the National Academies’ physical location in Washington, D.C., Baxter offered a land acknowledgement to the Nacotchtank Piscataway people and elders past, present, and future. He shared the roundtable’s recognition that health and quality of life are shaped by interdependent factors and described the roundtable’s mission as being to “provoke and catalyze urgently needed multisector collaboration and action.” The roundtable hosts several workshops a year that bring together people from different perspectives, disciplines, and sectors to explore and share work related to improving equity and well-being in U.S. communities. The roundtable has previously held multiple workshops on funding which have been summarized in Proceedings of a Workshop, including a 2014 publication exploring hospital and
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1 The planning committee’s role was limited to planning the workshop, and the Proceedings of a Workshop has been prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants and are not necessarily endorsed or verified by the National Academies of Sciences, Engineering, and Medicine, and they should not be construed as reflecting any group consensus.
health system community benefit spending2 and payment system reform, community development investments, and pay for success financing.3 This workshop was designed to revisit those funding topics explored in the 2014 workshop and to discuss the current state of population health funding as well as existing challenges and opportunities encountered by organizations engaged in the work of assembling and deploying funding for population health improvement efforts. Despite system failures which have been magnified by the pandemic and a flawed pandemic response, the work in communities has persisted and generated both long-term and innovative solutions to improving population health. The workshop was intended to shed light on strategies that aim to conduct the work in an accountable and sustainable way. This workshop was a virtual event and included a virtual chat function where participants were able to ask questions throughout the event.
WORKSHOP OVERVIEW
In setting the stage for the workshop, the planning committee, whose charge is provided in Box 1-1, identified several objectives:
- Discuss existing upstream funding strategies that are designed to improve population health4 and health equity
- Explore the meaning of accountability to the community5
- Highlight progress in population health funding over the last few years
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2 Community benefit refers to “programs or activities that provide treatment or promote health and healing as a response to identified community needs. Community benefit programs have a special focus on the disadvantaged populations and must be available to the broad community. According to the Internal Revenue Service, to count as a community benefit, a program or activity must respond to a demonstrated health-related community need and seek to achieve at least one community benefit objective: increase access to health services, enhance public health, advance knowledgeable through education or research, and relieve or reduce a burden of government to improve health.” (https://www.communitybenefitinsight.org/?page=info.glossary# [accessed August 28, 2023]).
3 Financing Population Health Improvement: Workshop Summary https://nap.nationalacademies.org/catalog/18835/financing-population-health-improvement-workshop-summary (accessed 8/23/2023). For the activity page for this event, see https://www.nationalacademies.org/event/02-26-2014/resources-for-population-health-improvement-a-workshop (accessed August 24, 2023).
4 See the working definition of population health under Description on the roundtable’s web page (nas.edu/pophealthrt).
5 See a definition of community in Improving Health in the Community (1997): https://nap.nationalacademies.org/catalog/5298/improving-health-in-the-community-a-role-for-performance-monitoring (accessed August 28, 2023).
- Discuss recent developments and the emergent workload
- Detail what can be learned from research and evaluation
Although the workshop did not offer “the” authoritative definition of what it means to be accountable to community, several speakers provided helpful hints. Box 1-2 identifies the various thoughts provided by the speakers regarding the meaning of accountability to community.
ORGANIZATION OF THE PROCEEDINGS
This publication is organized into six chapters according to the workshop panels. Following the introductory chapter (Chapter 1), chapters 2 through 5 include both opening remarks and presentations given by a panel of speakers, followed by a discussion that integrates questions from the audience and the panelists’ answers. Chapter 2, titled Context and Overview, provides an overview of recent developments in the domain of population health funding and accountability to community. Chapter 3, Progress in Population Health Funding, highlights examples from the field demonstrating progress in funding over the last decade. Chapter 4, Emerging Challenges and Opportunities, details lessons learned from current population health funding pilots and initiatives. Chapter 5, Research and Evaluation, examines the role of research and evaluation efforts in population health work and accountability to communities. Chapter 6 summarizes closing remarks provided by Raymond Baxter. References are provided in Appendix A, planning committee biographies can be found in Appendix B, the agenda for the workshop is in Appendix C,
and the readings and resources provided to workshop attendees as part of the attendee packet are available in Appendix D. This proceedings has been prepared by the rapporteurs as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual workshop participants and are not necessarily endorsed or verified by the roundtable or the National Academies, and they should not be construed as reflecting any group consensus.
