National Academy of Medicine

Governmental Public Health and the Economics of Adaptation to Population Health

By Glen P. Mays
March 06, 2014 | Discussion Paper

In this discussion paper, Glen Mays describes recent experimentation with population health strategies that has been spurred by the ACA and by state health reform. Population health strategies involve varied stakeholders in the public and private sectors. The evolution in the landscape of actors, along with ACA implementation and factors including economic challenges, are leading to a reexamination of how governmental public health agencies are organized, and of their activities and financing. An IOM report and other sources have described the heterogeneity of public health agencies and their activities, which in some cases include the provision of clinical health care services, and similar heterogeneity in how those activities are financed. Aside from inefficiencies, heterogeneity is problematic because it creates deep disparities in the level of health protection received by communities.

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Disclaimer: The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.