Cheat Sheet

Population health cheat sheets

    Health systems face increasing pressure to improve population health and reduce the total cost of care. Download our cheat sheets to get smart on population health basics—fast. Each installment includes an overview of a key concept, why it matters, and how it works.

    Behavioral Health

    Behavioral health encompasses people’s psychological well-being and ability to function in everyday life. Behavioral health conditions include mental health disorders and substance use disorders.

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    Care Management

    Care management programs help patients navigate clinical and non-clinical services and improve self-management. Services include personalized care planning, chronic disease management, and patient education, among others.

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    Patient Engagement

    Patient engagement initiatives aim to increase patients’ level of involvement and ability to manage their health and health care. Patient engagement helps support smooth patient recovery, care plan and medication adherence, and ongoing self-management.

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    Social Determinants of Health

    Social determinants of health (SDOH) are non-clinical factors that impact one’s health. These factors include economic stability, food security, and neighborhood and physical environment.

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    Value-based Payment Models

    Value-based payment models financially incentivize provider organizations to reduce costs and improve care quality. There are several different models that differ in scope, design, complexity, and financial risk.

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    CMMI’s Direct Contracting Model

    Direct Contracting is a new value-based payment model available for the first time in 2021. Learn how the model works to assess your organization’s readiness to take on significant downside risk.

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