What Good Population Health Means To Your Paycheck

A population's health could determine the growth of your income, a community’s economy and a lower unemployment rate, a new analysis shows.

By examining the adverse health conditions from medical claims of more than 40 million commercially insured Blue Cross and Blue Shield health plan enrollees, researchers from Moody’s Analytics showed “healthier areas tend to have faster job growth, population growth and income growth.”

“Moving from a county of average health to the 99th percentile is associated with an increase in average annual pay of $5,793 and a 0.8-percentage point decline in the unemployment rate,” the Moody's report, done with the Blue Cross and Blue Shield Association, said.

“In a county in the 90th percentile of health index, average healthcare costs as provided by BCBS are 6% lower than for a county in the 10th percentile,” the Blue Cross report, which is part of the association’s “Health of America” series, says. “Where populations are healthier, we observe lower unemployment, higher income and higher pay.”

Researchers said five conditions--depression, anxiety, hypertension, diabetes and high cholesterol--are responsible for 30% of a population's “adverse health” as measured by the Blue Cross Blue Shield Health Index, which Moody's used to zero in on health conditions that have the greatest impact on commercially insured Americans. Moody’s researchers also looked at various economic variables including unemployment rate, per capita income, poverty rate and average annual pay. “The BCBS Health Index shows that health and the economy’s performance go hand in hand,” Mark Zandi, Moody’s Analytics’ chief economist, said in a statement accompanying the report.

The index only looked at the commercially insured population that would tend to have higher incomes than those with government insurance like Medicaid or Medicare. Eventually, the Blue Cross association wants to look at the Medicare and Medicaid population, but believes the data and report will be useful for policymakers.

“When they are looking at the health of their local market, they need the whole picture,” Blue Cross and Blue Shield Association chief strategy officer Maureen Sullivan said in an interview. “It’s critical to focus on the health of your local communities. You need to have a measure of health.”

Blue Cross and Blue Shield plans including Anthem, as well as insurers like Aetna , Cigna and UnitedHealth Group , are increasingly shifting away from fee-for-service payment to value-based models. These insurers increasingly tie reimbursement of doctors and hospitals to quality measures and health outcomes of populations of patients, making sure they are getting the right care in the right place and at the right time.

“Even after controlling for demographics and statewide factors, the correlation is robust for most outcomes,” the Blue Cross and Blue Shield report said. “The association between health and the pace of economic growth is even stronger. Healthier areas tend to have faster job growth, population growth and income growth even compared with areas with similar demographics within the same state.”

The Blue Cross Blue Shield Health Index “quantifies how more than 200 common diseases and condition categories affect overall health and wellness by assigning each county a health impact measure between 0 and 1, designating the proportion of optimal health reached by the county’s population.”