Altarum's Private Insurance Research Collection

Commissioned Projects

Health Reform Impacts on Multi-Sector Networks that Support Population Health, Cezar Mamaril, Glen Mays, University of Kentucky College of Public Health

Health reform measures in the Affordable Care Act (ACA) created new resources and incentives for hospitals and other health sector organizations to contribute to disease prevention and health promotion activities. These upstream population health initiatives were informed by evidence suggesting public health and prevention investments were associated with improved population health outcomes and lower medical spending. While public health remains substantially underfunded, a community’s population health system capital is not only determined by the level of health spending, but also in the scope and availability of core public health activities implemented by the constellation of organizations that contribute to the population health system. This means that contributions to the population health system from hospitals and healthcare systems are not just limited to community benefit spending, but also in ways that hospitals can engagement and coordinate multi-sector collaborations to bridge, integrate, and align fragmented clinical health care, public health, and social service financing and delivery systems. This study has three aims: (1) Identify changes in community public health spending and changes in multi-sector networks supporting population health activities that have occurred following implementation of ACA, with a focus on contributions to population health from hospitals and other health sector organizations; (2) determine the social, economic, and policy factors that contribute to differences in the pre-post ACA trajectories of change in networks and spending across states and communities; and (3) estimate the impact of Medicaid expansion under ACA on multi-sector networks and contributions to population health. 1/1/19 – 6/30/19