The Health and Care Research Sub-committee launched a member-led working party in 2018 to support the development of population health management. The National Health Service (NHS) in the UK is tackling the challenge of rising healthcare demand and constrained funding by implementing new models of care to develop integrated local healthcare systems for a defined population. To underpin delivery of the improved outcomes, better care and value for money that are being sought, it is essential that healthcare systems develop a comprehensive understanding of the health characteristics of their population – for example, current patterns of care demand, forecasting future demand, and predicting the effects of interventions. The actuarial skillset has much to offer in building and deploying such demographic, risk modelling and analytical capability, but there is currently limited awareness of this across the NHS. 

Population Health Management considers the distribution of health outcomes within a population and how to impact these outcomes in the most optimal way for the group as a whole. It is a wide field and so the working party initially focussed on the specific topic of impactability modelling. The predictive risk stratification and segmentation models typically utilised in population health approaches have focused on identifying population groups that have a high risk of experiencing an adverse event, such as an unplanned hospital admission, or have a high-cost profile. 

However, the success of risk stratification at the whole-population level depends not just on identifying those most at risk of an adverse event, but rather in identifying those who are most at risk and most likely to respond positively to a given intervention – i.e. to be ‘impactable’. The combination of risk stratification, impactability modelling and actuarial variability analysis can not only help to target the most promising patients for medical management, but also support the improvement of resource allocation across a local health economy. 

KEY OBJECTIVES 

The research and output of the working party has been planned in phases. Initially, a range of topics related to impactability had been explored, including: 

definition of impactability modelling – (e.g. analysis which quantifies the extent to which a defined population cohort is predicted to respond to a given healthcare intervention under specified circumstances) 

exploring an understanding of different approaches to measuring and modelling impactability including the skills, tools and techniques needed to achieve each approach 

the advantages and disadvantages of various potential approaches (both data-driven and those based on empirical evidence) 

consideration of the interactions between impactability and population risk management 

issues of public perception, inequality and ethics. 

Chair: David Beddows 

Established: 2018