Standpoint | What is Meant by “Population” |
---|---|
Insurance company or health plan | People covered by an insurance product, eg, “members,” “enrollees,’’ “beneficiaries,” “covered lives.” May include private or public insurance, eg, Medicaid for safety-net systems. |
Medical groups or provider systems | People assigned to receive care through a provider group or delivery system, eg, “assigned patients” or “panels” |
Individual practices | People assigned or showing up for care, eg, “my patients,” “panels” or neighborhoods—whether they are seeking care or not |
Communities or community organizations | Groups of people with a shared characteristic, interest, risk factor, geography, or other commonality, eg, diabetes; children with special needs; veterans or occupational groups; cultural, ethnic, or racial groups; geographic neighborhoods or other communities of interest |
Note: The intersection of these terms: health insurance is organized around “enrollees” or “members” while care delivery systems are organized around “assigned patients” or “panels.” Several care systems and insurance companies may in effect “divide up” the population of multiple actual communities or larger geographic areas into enrollees (for insurance) and panels (for care), which count for the insurance company or delivery system as “our population” even though not a complete population or community. Communities of geography, interest, or shared characteristics may be served by multiple health plans and provider groups, or none at all—hence are also divided up for service by care delivery. This distribution of the people of actual communities across multiple health plans and provider groups amplifies the need for public health and other public and private action in concert with care delivery and insurance systems.