The document summarizes the key discussions and presentations from the 2016 Sixteenth Population Health Colloquium. The Colloquium focused on challenges in implementing population health strategies and achieving the goals of the Affordable Care Act. Key topics included understanding patient fear, creating a new population health protection agenda to reduce costs, using data and technology to improve care for older adults, and engaging consumers in wellness programs. Presenters emphasized the need for collaborative, integrated care and addressing social determinants of health to improve population health outcomes and control rising healthcare costs.

1. The 2016 Sixteenth Population
Health Colloquium:
Summary of Proceedings
Rachel S. Permuth, PhD, MSPH, Senior Director of Research, Hospitals,
North America & Principal Epidemiologist
Jennifer M. Petrelli, SM, MPH, Nutritional Epidemiologist

2. Population
Health in the
Affordable
Care Act
Institute for
Healthcare
Improvement’s
triple aim
§§ Expanded Insurance Coverage
§§ Improved Quality of Care
§§ Enhanced Prevention and Health Promotion
§§ Community and Population-based Activities
§§ Improving Population Health
§§ Improving the Experience of Care
§§ Reducing the Per Capita Healthcare Cost
Sodexo was honored to be a Silver Grantor and presenter at the 2016 Sixteenth Population Health
Colloquium, the leading forum on innovations in population health. The Colloquium, hosted by the
Jefferson College of Population Health, brought hundreds together to learn and engage in person and
online from March 7-9 in Philadelphia, Pennsylvania. The Colloquium provided information and updates
on health policy, healthcare trends, and practice and innovation. Real world examples of population
health management (PHM) initiatives that are improving care and outcomes were also featured.
The content presented at the Colloquium provided a variety of perspectives on the current and
future state of population health. Keynote speakers included David B. Nash, MD, MBA, FACP, Dean
of the Jefferson College of Population Health at Thomas Jefferson University and Chair of the
Population Health Colloquium; and Julie Gerberding, MD, MPH, Executive Vice President, Strategic
Communications, Global Public Policy, and Population Health, Merck; Former Director U.S. Centers for
Disease Control and Prevention (CDC).
Conference highlights included sessions on engaging stakeholders in population health, viewing
population health as a service, effectively using technology and data analytics, engaging and
empowering communities, and innovative population health programs. The overarching theme that
emerged from the Colloquium is that although the focus in today’s healthcare environment is already
on improving population health and achieving better outcomes for patients, integrated delivery systems
and large medical groups are having difficulty adapting to the increasing emphasis on PHM. In order to
pursue the Institute for Healthcare Improvement’s Triple Aim and goals set forth in the Affordable Care
Act of 2013 (see Figure 1), collaborative integrated care is essential.
Central to many sessions of the conference was the following question:§
Given the (ambitious) goal of population health, how can we create feasible solutions to deliver
better care and improve outcomes while simultaneously curbing costs?
Figure 1. Population Health in the ACA and the IHI’s Triple Aim
2 The 2016 Sixteenth Population Health Colloquium Proprietary and Confidential

3. Loners Worriers
Self-Centrics
Attention-
Seekers
FEAR
OF
THE
INSTITUTION
DEFLECT FEAR
INNERFOCUS
REACHOUT
TACKLE FEAR
Vitality
Recognition
Conviviality
Security
Listen
to
me
Bond
with
me
Singularize
my
stay
Respect
my
loneliness
Follow
my
plan
Regain
my
balance
From the information presented at the Colloquium, we have identified four key areas that will have
important ramifications as healthcare organizations seek to implement population health strategies:
1. Understanding and Alleviating Patient Fear is Key to Patient Experience
2. The Case for a New Population Health Protection Agenda as a Means to Drive Down Healthcare Costs
3. Using Data and Technology to Improve Healthcare for Older Adults
4. Engage Consumers in Wellness-based Population Health and Thrive Financially
Understanding and Alleviating Patient Fear is Key to Patient
Experience
In healthcare, medical advances alone cannot guarantee better patient outcomes. Helping patients
heal or overcome illness involves more than just treatment through medical procedures and products;
patients’ mental well-being and peace-of-mind can be just as important. Dr. Rachel S. Permuth, Senior
Director of Research, Hospitals, North America & Principal Epidemiologist, and Lisa Herms, Research
Manager, Healthcare of Sodexo, presented on the phenomenon of patient fear. The discussion around
this topic garnered great interest from the audience and started a lively question and answer session,
with various audience members sharing their own experiences and perspectives on patient fear.
In fact, understanding and alleviating fear is central to improving the Patient Experience. As
humans, we have core needs, and fear occurs when one of these needs is not being met. However, fear
in the hospital setting is amplified and much more complex. Top patient fears include infection and
germs, incompetence, and death. This fear typically revolves around two aspects: a loss of control and
depersonalization.
Though the underlying emotion may be universal, however, every patient experiences fear differently
(see Figure 2). It is therefore vital for healthcare organizations to look toward enhancing patient
experience in the hospital setting through initiatives targeted at these different manifestations of fear.
Staff awareness, patient involvement, and social support are essential for overcoming patient fear and
are key areas for improvement.
Figure 2. Sodexo’s PersonixTM
Visualization of Different Manifestations of Patient Fear
Proprietary and Confidential The 2016 Sixteenth Population Health Colloquium 3

4. The Case for a New Population Health Protection Agenda as a
Means to Drive Down Healthcare Costs
Dr. Julie Gerberding, EVP, Merck & Co., Inc. and Former Director, U.S. Centers for Disease Control
and Prevention (CDC), outlined her thoughts on the population health landscape. She focused on the
following key issues:
§§ Potential causes of the “health disadvantage” experienced in America relative to other high-
income countries.
§§ Opportunities and limits of the Affordable Care Act in closing the health gap.
§§ Motivating private sector leadership actions that will help improve population health in
worksites and communities, and inform local, state and national policies.
The U.S. has relatively unfavorable health outcomes compared to other high-income countries, despite
our vast expenditure on healthcare. The Organization for Economic Cooperation and Development
ranked the U.S. National Health Performance among 34 countries, and the U.S. ranked 26th in life
expectancy, 31st in infant mortality, 28th in low birth weight, and 25th in maternal mortality.
Why does the U.S. experience this “health disadvantage”? There are a variety of issues that are
hypothesized to contribute to the problem. One issue is that our healthcare system is inefficient and
encourages unnecessary, redundant, and expensive care. There are also public health system issues.
For example, our public health system is not adequately linked to the healthcare delivery system and
not adequately resourced to accomplish its mission. In 2014, only 3% of the nation’s health dollars went
towards public health. Other factors contributing to the health disadvantage are shown in Figure 3.
Figure 3. Determinants of the U.S. Health Disadvantage
Healthcare & Public
Health System
Issues
Shorter
life
expectancy
& poorer
health
status
Policies
& Culture
Economic &
Psychosocial
Factors
Physical
& Social
Environment
Individual
Health
Behaviors
U.S.
Hea
lth
Disa
dva
n
tage
4 The 2016 Sixteenth Population Health Colloquium Proprietary and Confidential

5. Dr. Gerberding emphasized that “the most powerful opportunity for stopping the growth in the cost
of healthcare in the United States is to create more health in the population.” She further discussed
the idea that health improvement is not only brought about in the doctor’s office or the ACO. Healthy
behaviors are fostered in our homes, schools, worksites and communities. The problem is that we are
not investing in programs and services that improve health and well-being from a broader perspective.
Creating a holistic health system that promotes better health and greater health equality is imperative.
According to Dr. Gerberding, private sector leaders, especially those in the health sector, have a unique
opportunity – and responsibility – to catalyze progress toward better population health. She called upon
private sector leaders to set the tone at the top, by providing smoking cessation benefits for employees,
nudging employees to choose healthier food choices and engage in physical activity and incentivizing
wellness in the design of benefits programs.
She also encouraged private sector leaders to foster alliances in community health networks by
engaging with public health leaders, committing leadership and resources to supporting priority
community efforts and putting “health” on the business agenda.
Proprietary and Confidential The 2016 Sixteenth Population Health Colloquium 5

6. Using Data and Technology to Improve Healthcare for Older Adults
Dr. Jaewon Ryu, MD, Segment Vice President and President of Integrated Care Delivery, Humana, Inc.,
spoke about seniors being the focus of population health for Humana. He emphasized that creating the
right environment makes it possible to expect improved health for older adults.
Humana is working to address multiple factors tied to the health of older adults, including:
§§ Casting a broader net from the traditional scope of the healthcare system to encompass
non-traditional areas that impact health. This includes access to nutritious food, chronic care
coordination, real-time monitoring of older adults and the use of technology (smartphones/tablets).
§§ Moving from traditional to integrated healthcare. In the traditional healthcare model patients often
experience dis-integrated, episodic and conflicted care. In the integrated healthcare-model, care is
patient-focused, primary care-centric and proactive.
§§ Preparing care providers for the new era of population health. Physicians need assistance in
transitioning from the volume-based to value-based model of care. There are significant gaps in the
transition toward value-based care, and many organizations are not ready to meet the challenge.
§§ Using data, analytics and technology to bring about results. The use of analytics allows for
actionable insights that drive value. Telehealth is also gaining prominence, including remote
monitoring as a way to extend care management and/or telemedicine/eVisits. For example, Dr. Ryu
noted that tele-dermatology improves patient access to care and reduces wait times from 21 days for
an appointment to 42 minutes for a patient to receive a care plan.
Data and technology are powerful tools in the integrated healthcare model. They can bring
interventions to a larger number of people and improve access to care. High-cost and high-risk
individuals can be targeted and resources can be appropriately deployed to get patients the care
they need, when they need it. It is critical that care providers receive assistance in adapting to new
innovations and other demands of today’s integrated, value-based system of care.
6 The 2016 Sixteenth Population Health Colloquium Proprietary and Confidential

7. Engage Consumers in Wellness-based Population Health and
Thrive Financially
Dr. David J. Peter, Chief Medical Officer and Laura Kukral, Director of Strategy of the Cleveland Clinic
Akron General Medical Center, Akron, Ohio, discussed how Akron General – a highly renowned and
influential Ohio hospital – views population health. Dr. Peter emphasized that “Population health is a
mode you take your organization into. It is a philosophy.”
Key community health priorities for Akron General include chronic diseases, mental health, access to care,
substance abuse, smoking cessation, elderly care support and obesity. These are concerns that are familiar
to health professionals involved in Community Health Needs Assessments in hospitals across the U.S.
Akron General has made wellness-based population health central to its mission for 20 years. They have
instituted three health and wellness centers, which include gyms. In fact, 35% of gym members become
first-time users of the Cleveland Clinic Akron General Health System after joining. Through these centers,
Akron is able to take its care a step further and deliver high-value care across the broader continuum.
Akron General Medical Center’s emphasis on the community is part of its success, and has moved it
from the red into the black.
Proprietary and Confidential The 2016 Sixteenth Population Health Colloquium 7

8. The key components of Akron General’s approach include community health improvement and
repositioning its brand around its wellness message. Through a focus on innovation in several key areas
(see Figure 4), Akron has been able to achieve its population health goals while also thriving financially.
Figure 4. Akron General Medical Center’s Key Areas of Focus for Population Health Improvement
A quote from Akron General’s CEO, Dr. Tim Stover, aptly sums up the underlying foundation of Akron’s
presentation. He stated that “We want to put smart minds around us who can help discover what
clinical prevention should really look like; and can define Medical Fitness best practices for the next
20 years.” Not only has this been a successful principle for Akron, but it can also serve as a guideline for
other healthcare organizations as they seek initiatives to achieve the same goal of population health.
Outreach
Research
collaboratives
Innovative
delivery
consumer
engagement
Partnerships to improve health of low SES groups
Mobile unit offering services (e.g., physicals, health
screenings, women’s health exams, educational classes)
Kent State University
Cleveland Clinic Wellness Institute
Health & Wellness Center
LifeStyles
8 The 2016 Sixteenth Population Health Colloquium Proprietary and Confidential

9. Conclusion
The 2016 Population Health Colloquium focused on several areas pertaining to the future of population
health in the era of value-based care. According to Dr. David B. Nash, the Dean of the Jefferson
College of Population Health, the definition of population health is still nebulous. Yet, population health
management is at the forefront of the healthcare agenda, and the goal of PHM is clear: to deliver higher
quality care and achieve improved health outcomes for populations.
Hospitals and other providers are now increasingly paid based on the quality and effectiveness of
their care, rather than the sheer volume of tests and other procedures they perform. Therefore, it is
necessary to not only address acute medical needs, but also the emotional and social well-being of
patients and the key social determinants of health of a community. More specifically, providers will have
to address factors that negatively impact the Patient Experience, such as patient fear, and improve
involvement with community entities in order to succeed.
To accomplish the ambitious aims of the population health agenda, collaborative integrated care is
required. The most powerful opportunity for stopping the growth of healthcare costs in the U.S. is
to foster improved health in the population. The private sector should strive to find shared value in
population health opportunities—such as diabetes prevention and population vaccine coverage—within
the community. Data analytics and technology can also bring meaningful interventions and improve
access to care. But physicians and health systems need assistance in meeting the challenges posed by
the new population health focus.
In sum, the Colloquium allowed for frank discussions about the current state of population health
and the challenges posed by the Affordable Care Act. However, speakers and audience members
acknowledged that many questions remain unanswered. Forums like the Population Health Colloquium
are critical for exchanging ideas and focusing on viable solutions to accomplish our nation’s population
health objectives.
Additional Resources
To learn more about the Population Health Colloquium, population health and Sodexo’s contributions to
population health initiatives, the following resources may be of interest:
Population Health Colloquium website: www.populationhealthcolloquium.com
Sodexo White Papers:
§§ “Sodexo’s Population Health Management: Approach & Key Role of Registered Dietitian Nutritionists”
http://viewer.zmags.com/publication/cd16a7af#/cd16a7af/1
§§ “Understanding and Managing Patient Fear in the Hospital Setting” http://viewer.zmags.com/
publication/0351c0e8#/0351c0e8/1
§§ “New Challenges Facing the Hospital C-Suite” http://viewer.zmags.com/
publication/1e16c929#/1e16c929/1
§§ “Communities for Health Launch Event Summary of Proceedings” http://viewer.zmags.com/
publication/dc43c72e#/dc43c72e/1
§§ “Going Beyond the Four Walls: Population Health Management (PHM) Partnership Strategies MUSC
& Sodexo” http://viewer.zmags.com/publication/c8359abd#/c8359abd/1
§§ “Ambulatory Networks: The Power of Technology” http://viewer.zmags.com/
publication/082d4227#/082d4227/2
Additional white papers can be found on Sodexo’s Thought Leadership Library: §
bit.ly/sodexothoughtleadership
Proprietary and Confidential The 2016 Sixteenth Population Health Colloquium 9

10. As part of Sodexo’s commitment to creating
a better tomorrow through sustainable, green
initiatives, this document has been printed on paper
containing 20% post-consumer recycled content.
9801 Washingtonian Boulevard, Suite 602
Gaithersburg, MD 20878
800 432 6663
www.sodexoUSA.com