Population Health & Integrated Care

According to the World Health Organization, people with severe mental health disorders have a higher prevalence of many serious chronic diseases and are at a higher risk for premature death as a result of those diseases than the general population. Current data suggests that adults in the U.S. living with serious mental illness die on average 25 years earlier than others, largely due to treatable medical conditions.1

Mid-State Health Network (MSHN) is committed to increasing its understanding of the health needs of individuals within its 21-county service region and finding innovative ways to achieve the goals of better health, better care, better value, and better provider systems by utilizing informed population health and integrated care strategies. The term population health refers to the health outcomes of a group of individuals; it is an approach to healthcare that aims to improve the health of an entire group of people (National Alliance on Mental Illness). 

MSHN has a comprehensive Population Health and Integrated Care Plan which was approved by the MSHN Board of Directors in January 2019. purpose of the MSHN population health and integrated care plan is to establish regional guidance and best practice in these areas as well as describe specific population health and integrated care initiatives currently underway in the MSHN region. Components of the plan include:

  • Identification of the population served by MSHN and key health needs
  • Identification of chronic co-morbid physical health conditions that contribute to poor health and drive health costs for individuals with behavioral health disorders
  • Description of social determinants of health (SDOHs) and prevalence data of common SDOHs in the population served by MSHN
  • Examination of key foundational areas necessary to support population health programs and evaluation of MSHN’s stage of readiness in each area
  • Description of current population health and integrated care initiatives underway by MSHN and its partner Community Mental Health Sservice Provider (CMHSP) organizations

The full Population Health and Integrated Care Plan is available here: 

MSHN Population Health and Integrated Care Plan 2024-2025 


Population Health & Integrated Care Reports

The Michigan Department of Health and Human Services (MDHHS) requires Pre-paid Inpatient Health Plans (PIHPs) to participate in certain integrated health activities and performance measures each year. The report linked below summarize MSHN and its CMHSP Participants' efforts in meeting MDHHS integrated health requirements during Fiscal Year 2023.

FY23 Performance Bonus Incentive Pool Narrative Report - Increased Participation in Patient-Centered Medical Homes