Hester, J. (2018). A balanced portfolio model for improving health: Concept and Vermont’s experience. Health Affairs, 37(4), 570-578.

Year: 2018


This article first summarizes Vermont’s experience as a laboratory for health reform. It then presents a conceptual model for a community-based population health strategy, using a balanced portfolio and diversified funding approaches. The article then reviews Vermont’s population health initiative, including an example of a balanced portfolio and lessons learned from the state’s experience. This article argues that a successful strategy for improving population health requires acting in several sectors by implementing a portfolio of interventions: the mix of interventions should be both tailored to meet the community’s needs and balanced in several dimensions—for example, time frame, level of risk, and target population. One identified obstacle is finding sustainable financing for both the interventions and the community infrastructure needed.

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