Population Health Management


Population health improvement is more than a goal for Access Health; it is the core of our strategic plan, in collaboration with our stakeholder partners, to achieve optimal health at both the individual and the community levels. While 20% of healthcare is maintained through provider health systems, the rest of optimal health is dependent on the health of our community. To achieve optimal health a community must align its health policies and resources, and engage its stakeholders in improving population health. Our strategy identifies the Domains of Health where community interventions of policy and resource alignment can build the health resiliency required to achieve and sustain optimal health.

At the individual level, Access Health provides an affordable C3 Health Plan coverage program for the low-income working uninsured in the community. C3 Health is unique as a community-based non-health insurance plan designed to promote wellness through its (CHI) processes. CHI empowers participants to take control of their health to achieve optimal health. In addition to C3 Health Plan, Access Health provides CHI in support of the hospital’s own community benefit coverage plan for those eligible for the hospital charitable care program. Collectively, these coverage initiatives provide a population health improvement framework for the community’s uninsured, contributing to health equity and population health improvement for the community at large.

At the community level, Access Health engages with our community stakeholders as a participant in the Community Health Improvement Region (CHIR). The Muskegon CHIR is a model test site under the Michigan State Innovations Model, funded by the Centers for Medicare/Medicaid Services (CMS). To achieve population health improvement, the CHIR developed a collective-impact process that: establishes a shared vision for the community; aligns policies and resources; and collectively impacts the population health of the community.

Through the CHIR’s collective impact process, Access Health and its partners have developed a Health Resilience Zone model to drive population health improvement at the neighborhood level. The model focuses on the social determinants of health that are outside the scope of the medical community. These social determinants of health are grouped within the eight domains of health, where community stakeholders can identify strategies for interventions based on the alignment of policies and resources.

The Access Health population health strategy involves engagement at the individual level through CHI, and engagement at the community level through the Health Resilience Zone model. The goal is to achieve population health improvement across the eight domains of health that is sustainable in a healthy and prosperous community.