Exploring the Roles & Functions of Health Systems within Population Health Integrator Networks

Goal of Work

In November 2018, the Kresge Foundation awarded Nemours Children’s Health System (Nemours) a 2-year grant to further its work on better understanding the ways that hospitals & health systems contribute to multi-sector networks that advance population-level health goals. This project will provide Nemours an opportunity to work with a range of researchers and practitioners to advance the field’s knowledge about the specific roles and functions these health entities in multi-sector population health integrator* networks carry out. The goal of the effort is to highlight effective practices that can inform and accelerate the work of hospitals & health systems that are seeking out new ways to partner with leaders from other sectors to advance health and equity in ecosystems across the United States.


Over the last decade, community-based organizations, educational entities and health system leaders across the U.S. have increasingly worked together to address complex challenges that underserved children and families in their cities, states and regions face. Collectively, the field continues to learn and define the value of streamlining and coordinating the delivery of a range of essential services across sectors. Beyond coordination of service delivery, the field is coming to a collective realization that advocacy and policy development efforts have great potential for institutionalizing gains for the most affected individuals, while contributing to systems changes necessary to impact social determinants of health in ways that improve the quality of life for entire communities.

Coordinating cross-sector work in a community or region requires one or more entities to carry out integrative functions that allow the sum total of the network’s efforts to achieve more than any individual member can do alone. Population health integrators play this convening role in the interest of helping networks advance population- level solutions to social problems that compromise the health and well-being of children and families in a given geography. While the literature around the structure and functioning of these multi-sector networks targeting population-level health goals has proliferated, an opportunity remains to better understand the mechanics of how hospitals & health systems join, catalyze, and contribute to the sustainability of these efforts.

Details of the Work

Drawing from a range of literature related to multi-sector partnerships, this project will highlight effective integrator networks for population health, and elucidate the roles and functions of hospitals & health systems within such networks. The work will be carried out along two dimensions:

1. Modernizing the “Integrator” Concept:

In 2012, Nemours staff and other stakeholders crafted a paper entitled “Integrator Role and Functions in Population Health Improvement Initiatives.” This paper outlines how hospitals & health care systems can, in collaboration with other community-based organizations, serve as integrators to achieve the “triple aim” of better quality of care, better health for populations, and lower costs. This project will allow Nemours to update this paper, including highlighting bright spot examples of integrated networks in which hospitals & health systems around the U.S. have partnered with stakeholders to achieve population-level health outcomes, and moved closer to achieving this triple aim, in their regions.

2. Using “Integrator Learning Labs” to Accelerate Adoption of Best/Promising Practices for Integrators:

We will select 8 communities from around the country to participate in a virtual “Integrator Learning Lab” in the first half of 2020. As “leaders and learners” in the Integrator Learning Lab, these communities will be paired with technical assistance providers to identify and adopt best practices for forming multi- sector partnerships aimed at improving population health in their regions. This Integrator Learning Lab will build upon the successful Policy Learning Lab (PLL) model that Nemours developed as part of its Moving Health Care Upstream initiative in 2017. The PLL is a technical assistance model aimed at accelerating the uptake of evidence-informed local public policies and/or institutional policies that strengthen upstream population health initiatives.

For more than a decade, Nemours has partnered with others to accelerate pediatric population health improvement and health system transformation. Modernizing the integrator concept, and establishing a learning lab that can accelerate scale of this model in regions across the U.S., will provide a pathway for how integrated networks with strong health system partners can improve population-level health outcomes and help create more healthy, vibrant communities for children and families in their regions.

For more information, please contact Bilal Taylor (bilal.taylor@nemours.org), Program & Policy Analyst with the Nemours National Office of Policy & Prevention.

*Nemours defines “population health integrators” as entities that serve a convening role and work intentionally and systematically across multiple sectors in a region to achieve a common purpose specific to health outcomes of an entire geography of people.