Elements of Accountable Communities for Health: A Review of the Literature

Mongeon, Marie; Levi, Jeffrey; Heinrich, Janet

doi:10.31478/201711a

Cited by 17 publications

(23 citation statements)

References 17 publications

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“…The current study showed that collaboration between an increasing number of stakeholders and extension of the portfolio of the PHM initiatives were mainly expected in the short term, while more experiments with new payment models and funding were mainly expected in the middle and long term. These results are in line with previous literature, which has shown that specific activities are associated with specific phases in PHM development [18, 19].…”

Section: Discussionsupporting

confidence: 93%

How executives’ expectations and experiences shape population health management strategies

Steenkamer

Drewes

Vooren

et al. 2019

BMC Health Serv Res

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BackgroundWithin Population Health Management (PHM) initiatives, stakeholders from various sectors apply PHM strategies, via which services are reorganised and integrated in order to improve population health and quality of care while reducing cost growth. This study unravelled how stakeholders’ expectations and prior experiences influenced stakeholders intended PHM strategies.MethodsThis study used realist principles. Nine Dutch PHM initiatives participated. Seventy stakeholders (mainly executive level) from seven different stakeholder groups (healthcare insurers, hospitals, primary care groups, municipalities, patient representative organisations, regional businesses and program managers of the PHM initiatives) were interviewed. Associations between expectations, prior experiences and intended strategies of the various stakeholder groups were identified through analyses of the interviews.ResultsStakeholders’ expectations, their underlying explanations and intended strategies could be categorized into four themes: 1. Regional collaboration; 2. Governance structures and stakeholder roles; 3. Regional learning environments, and 4. Financial and regulative conditions. Stakeholders agreed on the long-term expectations of PHM development. Differences in short- and middle-term expectations, and prior experiences were identified between stakeholder groups and within the stakeholder group healthcare insurers. These differences influenced stakeholders’ intended strategies. For instance, healthcare insurers that intended to stay close to the business of care had encountered barriers in pushing PHM e.g. lack of data insight, and expected that staying in control of the purchasing process was the best way to achieve value for money. Healthcare insurers that were more keen to invest in experiments with data-technology, new forms of payment and accountability had encountered positive experiences in establishing regional responsibility and expected this to be a strong driver for establishing improvements in regional health and a vital and economic competitive region.ConclusionThis is the first study that revealed insight into the differences and similarities between stakeholder groups’ expectations, experiences and intended strategies. These insights can be used to improve the pivotal cooperation within and between stakeholder groups for PHM.Electronic supplementary materialThe online version of this article (10.1186/s12913-019-4513-3) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 93%

How executives’ expectations and experiences shape population health management strategies

Steenkamer

Drewes

Vooren

et al. 2019

BMC Health Serv Res

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“…The idea that these mechanisms are universal is supported by the mechanisms, which are very similar in nature, identified in a five-year research program which monitored the development of nine PHM initiatives in the Netherlands (Van Vooren, 2019). This international study shows that it is important to secure commitment to the PHM initiatives' vision and goals (Towe et al, 2016;Siegel et al, 2018;Mongeon et al, 2017). To enable such commitment, more formal top-down enforcement of commitment through e.g.…”

Section: Discussionmentioning

confidence: 92%

Implementing population health management: an international comparative study

Steenkamer

Weger

Drewes

et al. 2020

JHOM

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PurposeThe purpose of this paper is to gain insight into how population health management (PHM) strategies can successfully integrate and reorganize public health, health care, social care and community services to improve population health and quality of care while reducing costs growth, this study compared four large-scale transformation programs: Greater Manchester Devolution, Vancouver Healthy City Strategy, Gen-H Cincinnati and Gesundes Kinzigtal.Design/methodology/approachFollowing the realist methodology, this explorative comparative case-study investigated PHM initiatives' key features and participants' experiences of developing such initiatives. A semi-structured interview guideline based on a theoretical framework for PHM guided the interviews with stakeholders (20) from different sectors.FindingsFive initial program theories important to the development of PHM were formulated: (1) create trust in a shared vision and understanding of the PHM rationale to establish stakeholders' commitment to the partnership; (2) create shared ownership for achieving the initiative's goals; (3) create shared financial interest that reduces perceived financial risks to provide financial sustainability; (4) create a learning environment to secure initiative's credibility and (5) create citizens' and professionals' awareness of the required attitudes and behaviours.Originality/valueThe study highlights initial program theories for the implementation of PHM including different strategies and structures underpinning the initiatives. These insights provide a deeper understanding of how large-scale transformation could be developed.

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“…Notably, complicated power dynamics are likely to remain even when community members are empowered. For example, community members can be discouraged from participation in decisionmaking processes by the use of technical language and jargon [18,23]. Addressing such dynamics may require activities such as developing a shared language between collaborators and community members [16].…”

Section: Active Engagementmentioning

confidence: 99%

Community Voice in Cross-Sector Alignment: Concepts and Strategies from a Scoping Review of the Health Collaboration Literature

Petiwala

Lanford

Landers

et al. 2020

Preprint

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BackgroundHealth care access is an important driver of population health, and factors beyond health care also drive health outcomes. Recognizing the importance of the social determinants of health (SDOH), different actors in the health care, public health, and social service sectors are increasingly collaborating to improve health outcomes in communities. To support such collaboration, the Robert Wood Johnson Foundation recently developed the cross-sector alignment theory of change. According to the cross-sector alignment theory of change, community voice is critical for helping collaboratives address community health needs. Yet research on health collaboratives offers little guidance on how community voice should be understood, or which community voice strategies are most effective.MethodsThis study addresses a gap in the literature with a systematic scoping review of research on health-oriented collaboration and community voice. By scanning key academic journals, searching three academic databases, and obtaining documents from across our professional networks, we identified 36 documents that address community voice in health collaboratives. The review reveals several concepts of community voice and a range of community voice strategies.ResultsWe find that community voice strategies fall into two broad approaches: active and passive. These vary in the level of engagement required from the community and in the level of power shared between communities and collaborators, and this in turn has implications for community health outcomes. We also find that while most strategies are discussed in the context of short-term collaboration, many also lend themselves to adoption in the context of sustainable collaboration and, ultimately, cross-sector alignment.ConclusionThis review provides a characterization and conceptualization of community voice in health-oriented collaborations that provides a new theoretical basis for future research. Passive and active community voice strategies can be studied in more detail for their expected impact on health outcomes and disparities. The increased attention to active community voice can help practitioners achieve improved health outcomes and researchers understand the pathways to health improvement through collaboration.

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Elements of Accountable Communities for Health: A Review of the Literature

Cited by 17 publications

References 17 publications

How executives’ expectations and experiences shape population health management strategies

How executives’ expectations and experiences shape population health management strategies

Implementing population health management: an international comparative study

Community Voice in Cross-Sector Alignment: Concepts and Strategies from a Scoping Review of the Health Collaboration Literature

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