www.HCTProject.com • 291
Population Health Management:
American Healthways’ PopWorks
Population health management is rapidly developing into
one of the key areas of focus for payers, employers, and
providers helping to manage and moderate increases in
health care costs. Population health management is focused on
improving the health and, therefore, reducing the health care
expenditures for the portion of the population that is driving the
majority of the health care cost.
The early years of disease management focused on one,
or just a few, core chronic conditions, such as diabetes, conges-
tive heart failure or chronic obstructive pulmonary disease. In
recent years, the focus has become broader and now includes a
much wider set of chronic diseases and other conditions that
drive a significant amount of the cost in our health care system.
True population health management goes beyond traditional
utilization and disease management; it seeks to better manage
the care and health of both chronically ill patients and those
patients who are at high risk but have not had an acute event.
This new model of care leverages innovative technology and
resources to strengthen the patient-physician relationship to have
sufficient penetration and impact to significantly bend the trend
of health care cost inflation for the entire population.
Population health management uses a variety of proactive
interventions, many of which also are used in typical disease
management programs – for example, personal nurse care man-
agers assigned to high-risk patients such as those with diabetes
and/or cardiac disease. These nurses and health care profession-
als, working with the patient’s physician, tailor treatment pro-
grams for the various clinical
conditions – e.g., blood sugar
testing, retinal eye exams, weight
and diet management, smoking
cessation, daily weight checks,
and usage of aspirin or beta
blockers – to help reduce the
occurrence of acute episodes of
care caused by these diseases.
Information from th