Description

This article outlines a suggested road map and practical considerations for health systems that are building or planning to build population health capabilities to meet the needs of their local markets. Traditional core capabilities needed to address the medical determinants of health for a population are reviewed. An innovative approach to community service integration to address the social determinants of health and the engagement of families to improve their own health and well-being is shared. The foundational approach is to connect insurance products, the health care delivery system, and community service agencies around the family’s well-being goals using human-centered design strategy.