AIR FORCE - AFI 44-173
|Publication Date:||10 January 2019|
Purpose of Population Health
The purpose of population health in the Air Force Medical Service is to improve the health of Air Force Medical Service beneficiaries by assessing determinants of health and defined outcomes for a defined group of people (i.e. population) in order to drive strategies, policies and interventions that maintain and improve those outcomes for the entire population as well as for all subgroups within that population.
Population health steps beyond an individual-level focus of medicine by considering the factors that affect both populations and individuals. These factors include (but are not limited to) individual and group behavior, social and physical environment, culture, health literacy, support networks, resiliency, genetics, lifestyle and healthcare resources.
Population health incorporates the concepts of population health management and medical management for people across the continuum of healthcare needs. This includes needed primary, secondary, and tertiary prevention throughout that continuum.
Purpose of Medical Management
The medical management of patients is a collaborative effort between Air Force Medical Home, specialty/ancillary services, and military/community stakeholders to ensure the planning, coordination, and delivery of appropriate healthcare services for wounded, ill, or injured service members as well as other beneficiaries.
Medical management is integrated under the tenets of population health because of shared goals and objectives. It addresses the needs of chronically ill patients as well as those deemed to be at increased risk for chronic or disabling conditions or those who may require care beyond routine primary care. The intent is to improve patient outcomes and to promote the efficiency and effectiveness of the healthcare delivery system. This is accomplished through support of population health, health promotion, and Air Force Medical Home activities and includes coordination of efforts to improve healthcare access and quality of care while simultaneously decreasing cost and variation in care management.
The medical management team is staffed by Health Care Integrators, Disease Managers, Utilization Managers, and Case Managers (including discharge planning and complex care coordination).