Challenge 2: Continuity

Abstract

Over the last few decades, several shifts have occurred in how health is thought of and how health care is delivered. First, what was once disjointed episodes of care delivery is being replaced by comprehensive and continuous care across settings and in the home. This contributes to blurring the lines between the individual activities involved in care delivery and the promotion and maintenance of population health. However, different players in the healthcare system have different financial incentives for care delivery and population health; these do not always align with new expectations of roles and responsibilities. Coupled with this is a greater understanding that individual health is more than just absence of disease. Often, individuals are neither “healthy” nor “sick”; instead, their level of health exists on a continuum where multiple factors are at play. Finally, there is a lack of continuity in health policy and reimbursement mechanisms as all sectors move toward value-based care and away from fee-for-service payments. Together, these aspects of continuity (or lack thereof) make it difficult to isolate the components of health and health care in order to evaluate and understand the value of each.