David Nash's "Dirty Dozen" Population Health Trends

David Nash, MD, Dean of Jefferson College of Population Health, kicked off the Eighteenth Population Health Colloquium.

David Nash, MD, kicked off the Population Health Colloquium in Philadelphia, Pennsylvania, with a rundown of a “dirty dozen” population health issues that had caught his attention in the last year. Really, it might have been 11 issues: His 12^th point was mostly unrelated to everything about the meeting, other than its location.

Here are the “12” areas, many encouraging and some troubling, that the Dean of the Jefferson College of Population Health at Thomas Jefferson University brought up at the start of the meeting:

1. More Americans are uninsured than a year ago, “regrettably and amazingly,” according to Nash.

2. HHS Director Alex Azar and CMS head Seema Verma are embracing value-based care. Pointing to their speeches at the HIMSS meeting earlier this month in Las Vegas, Nash noted gladly that, “They somehow drank the Kool-Aid and it appears that they’ve embraced the inexorable journey from volume to value, they are now coming around to our way of thinking."

3. The Medicare Payment Advisory Commission (MedPAC) recently decided to publicly criticize MACRA and call for its repeal. He described that decision as troubling and “a real headscratcher.”

4. There's a new wave of industry marriages, like CVS and Aetna or Cigna and Express Scripts. “Others, not me,” he said slyly of the latter, “Have called that the fox buying the henhouse.”

5. “The #1 issue in exit polling was preserving Obamacare,” he said of last week's special election in Pennsylvania’s 18^th Congressional District. “That gives me some hope for the future.”

6. There is an increased focus on social determinants of health, according to Nash. Jefferson has itself moved towards trying to understand these determinants in communities, with the opening of an offsite research center in Johnstown, Pennsylvania, hundreds of miles from the system’s urban core.

7. There's a greater public interest in population health and “the state our non-system.” Nash pointed to the rise of New York Times bestsellers on the topic, like 1 written by Ezekiel Emanuel, which evidence a growing appetite for exploration of the topic.

8. More health systems are trying to fill Chief Population Health Officer positions, he said.

9. The healthcare industry is seeing an influx of private equity money—"The likes of which the world has never seen.”

10. The industry is showing an increased focus on the wellbeing of those who deliver care. “In our great country nurses, pharmacists, and physicians need support as well,” Nash said. Because of this, healthcare is, “moving from the triple aim to the quadruple aim."

11. But, “We are a sicker society than we were a year ago,” he said. “Lifespan for our millennial children is going down, in large part to the diseases of despair, like drug addiction.”

12. “You’re sitting in the city of the Super Bowl champions,” he closed on an unrelated note, tipping the Philadelphia Eagles cap he wore throughout his opening comments. About half of the crowd met that point with rapturous applause.