A Balanced Portfolio Model For Improving Health: Concept And Vermont’s Experience

Health Affairs recently published an article by James Hester (IBHPC Stakeholder Advisory Board member) about Vermont's efforts to rationalize health care delivery over the past decade or so. Jim had a front-row seat for much of this dramatic activity as a staffer for the state and later for CMS. It is well-written, engaging, and makes a compelling case for considering a holistic approach to social welfare as a vehicle for improving health and health care.

Hester J. A Balanced Portfolio Model For Improving Health: Concept And Vermont’s Experience. Health Affairs; April 2018. https://doi.org/10.1377/hlthaff.2017.1237

Abstract: A successful strategy for improving population health requires acting in several sectors by implementing a portfolio of interventions. The mix of interventions should be both tailored to meet the community’s needs and balanced in several dimensions—for example, time frame, level of risk, and target population. One obstacle is finding sustainable financing for both the interventions and the community infrastructure needed. This article first summarizes Vermont’s experience as a laboratory for health reform. It then presents a conceptual model for a community-based population health strategy, using a balanced portfolio and diversified funding approaches. The article then reviews Vermont’s population health initiative, including an example of a balanced portfolio and lessons learned from the state’s experience.

Great work, Jim!

- Ben Littenberg