Policies and programs and body the third dimension of the Kindig model. Where in public, private, and nonprofit partnerships at the local, state, and federal levels, assume the complex population health management call to action to address challenges and leverage opportunities. Improving health requires the active involvement of diverse stakeholders, government, providers, insurers, academia, employers and unions, the media, philanthropy, political leaders, community organizations, and others. All stakeholders have a role in making population health a priority, focusing on health disparities, and adopting a health in all policies approach when identifying how decisions and multiple sectors affect health, and how improved health can support the goals of these multiple sectors. Policies focused on health promotion and disease prevention can be implemented at different levels from an individual school or workplace to municipal, regional, state, and national levels. Examples of affective health policies include regulations on tobacco products, excise taxes on alcohol, seat belt laws, specifications for food content labeling and supermarkets and restaurants, and regulations for ensuring air and water quality. Effective health programs not only in compass efforts to improve access to health care an individual behavior, but they also work to create healthy options and opportunities in the environments in which people live, learn, work, and play. Programs aimed at population health improvement address the full range of health determinants and factors. Examples of effective health programs include promoting healthier school lunches, encouraging fruit and vegetable consumption, funding bicycle paths and pedestrian friendly sidewalks, and expanding the development of parks. In 2016, the National Academy of Medison launched the Vital Directions for Health and Health Care initiative, which commissioned expert papers on 19 priority focus areas for US health policy. One of the papers, Advancing the Health of Communities and Populations of Vital Direction for Health and Health Care used kindig's model in the proposal of four goal opportunities for advancing prevention and population health. In their execution of a triple aim strategy, the Centers for Medicare and Medicaid Services, CMS, aligns with the goal opportunities articulated in the Vital Directions for Health and Health Care initiative, through its Center for Medicare and Medicaid Innovation or CMMI. In 2016, the CMMI, which was established by the ACA, announced a new accountable health communities model focused on connecting Medicare and Medicaid beneficiaries with community services to address health related social needs. However, Medicare advantage and Medicare supplemental benefits must be primarily health related, which means that the primary purpose is to prevent, cure, or diminish an illness or injury. This rule places some restrictions on the use of potential benefits that might affect health outside the traditional health system, like groceries and non ambulance transportation. Social factors by themselves have been explicitly prohibited from qualifying in in Rowley for meal service benefits. However, recent state Medicaid waivers are beginning to allow funding for some social determinants, and CMS is allowing more value based insurance design components to include some aspects of programs that benefit health related social needs. Passed in 2018, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic, Chronic Care Act, makes significant policy changes to advance the goals of integrated person centered care for Medicare beneficiaries and those dually eligible for Medicare and Medicaid. The law relaxes restrictions on Medicare advantage supplemental benefits to address barriers to health, such as covering services like adult day care, support for family caregivers, pest control, and other benefits that help members maintain or improve their health or overall function. As an approach, population health focuses on inner related conditions and factors that influence the health of populations over the life course. It identifies systemic variations in their patterns of occurrence and applies the resulting knowledge to develop and implement policies and actions to improve the health and well being of those populations. The imperative for population health management is to develop effective policies and deliver effective programs, interventions designed to maintain or improve the health of the population across the full continuum of care. These interventions must range from enabling the low risk healthy individual to maintain good health outcomes, to identifying, managing and improving the health outcomes of high risk individuals facing adverse determinants of health, chronic disease, impacts from aging, and/or access to Healthcare.
