Population Health

Striving to help you live healthier

We are working to ensure you have the support you need to be as healthy as possible no matter where you are, whether it’s in our hospitals or clinics or in the community. We recognize the best medical treatment is not needing treatment at all. That's why we are as focused on prevention as we are on life-saving clinical care.

What is Population Health?

Population Health is “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” The focus of Population Health work is to improve health outcomes for populations and communities as well as individual patients. We believe that if the community around you is healthy, you will be healthier.

What does Population Health at UW Health do?

The Office of Population Health at UW Health partners with our providers and staff to develop programs designed to improve health. These programs may take place in the hospital, clinic, community or in your home.

Population Health works in three main areas:

  • Population health care models

  • Accountable Care Organization

  • Community health improvement

Some examples of our work

  • Behavioral health services integration into primary care to help address issues like depression, anxiety and substance use disorders.

  • Nurse-led care coordination program to specifically support complex medical conditions through one-on-one education, goal-setting, coaching and support.

  • Community and healthcare partnerships to implement multiple strategies that support healthy birth outcomes in the African American community.

  • Patient screening process for social needs to ensure we have supportive resources in place at UW Health and in our community to address those needs.

  • Developed an Accountable Care Organization (ACO) in Wisconsin in 2013 that is recognized among the nation's best for quality and value. Our ACO participation enables us to develop innovative programs and services designed to improve the health of our patients.

  • Work with the City of Rockford and surrounding communities to ensure that everyone have access to the basic resources they need to live a healthy life.

  • Integrate specialty trained pharmacists in each level of the health care continuum to help optimize medication regimes and decrease out-of-pocket costs.

  • Distribute Narcan (Naloxone) and education in the Rockford community with those who are active in their addiction and attempting recovery.

  • Offer an overnight warming café from January through March to give unhoused members of the Rockford community a free, warm place to stay.

  • Partner with the Safe Communities (Wisconsin) and SOLARAS (northern Illinois) teams of recovery specialists to support those who wish to stop the cycle of addiction.

Caring for patients with opiod use disorder: Hub and Spoke

Accountable Care Organization

Putting you at the center of care

A medical provider using a stethoscope on a patient
As an Accountable Care Organization in Wisconsin, UW Health and its partners are committed to putting you at the center of care, keeping you informed and honoring your choices, customs and beliefs. We work to better coordinate your care whether you are in the primary care office, seeing a specialist, admitted to the hospital or at home.

Community health improvement

Establishing priorities for community health and programming

Three smiling children playing outside
As part of the Healthy Dane Collaborative in Wisconsin, UW Health recently assessed the health of the community through the lens of health inequities that can be linked to social, economic or environmental factors. Through this effort, UW Health heard community members voice a desire for equal opportunity, resources and respect and culturally responsive care, among other themes. We are actively and intentionally working to address longstanding health inequities through internal and external initiatives.

Diversity, Equity and Inclusion

Our commitment to equity

Our vision is to be a leader in dismantling racism in ourselves, in our system and in our community.

We know that systemic racism impacts the health of communities of color and leads to disparities in outcomes. We cannot improve the health of our community without addressing systemic racism and its impact on health. That's why we're continually assessing the needs of our community and forming partnerships to influence the many factors that contribute to health.

We work in partnership with our colleagues in Diversity, Equity and Inclusion and Community Relations on initiatives that promote health equity.

Learn about Diversity, Equity and Inclusion at UW Health

Learn about Community Relations at UW Health

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Your charitable gift makes a difference

Perhaps you are grateful for the care you or a loved one received from UW Health. Or you cherish living so close to a world-class, research-driven healthcare system that’s always there if you need it. No matter your motivation, every gift of any size means even better care for our patients.