David B. Nash, MD, MBA: Taking population health from volume to value

By David Woods, PhD, FCPP

The health––or specifically the nonhealth--of Philadelphia’s population presents a huge challenge: 23% of adults smoke; 31% are obese; the number of births to teenage girls is twice the national rate; and 59% of children live in single-parent households. Moreover, Philadelphia ranks as the poorest of the top 10 cities in the US, with fully one quarter of the population living in poverty. Even so, the city serves as a microcosm for health deficits affecting the nation as a whole

On the face of it, we have an army of people to meet this challenge: 5% of the American healthcare workforce is being trained here; there are five med schools; three major cancer centers, and schools of nursing and podiatry.

Dr. David Nash is well-equipped to serve as a general for that Army. Appointed as the inaugural Dean of Jefferson’s School of Population Health in 2008, he says its mission is to prepare leaders with global vision to examine the social determinants of health and to evaluate and develop health policies and systems to improve the health of populations.

His troops includes 40 full-time and 30 adjunct staff, working with a budget of $5.5 million. At the core of the population health enterprise is what he calls ‘crossing the bridge from volume to value.’ In other words, while conventional healthcare emphasizes cure, population health stresses prevention. Less, as Nash puts it, is more; so that unlimited access to care becomes timely, high-quality, cost-effective care, and traditional diagnosis and treatment become personalized wellness plans. So, he adds succinctly, ‘no outcome, no income.’

 Before becoming Dean, Dr Nash, 59, led Jefferson's department of health policy. He has multiple achievements in the fields of administration, academe, and publishing. He is the editor-in-chief of Population Health Management and the American Journal of Medical Quality. His many awards and honors include honorary Fellowship in the American College of Physician Executives, and being listed in Modern Healthcare as among the  nation’s 50 most powerful physician executives.

In the broad field of national health policy, Nash sees the 1600-page Affordable Care Act as volume, to be sure; but not as value since, he argues, it doesn’t really offer cost savings. Moreover, the ACA has left the public largely confused, with 18% believing that the legislation has already been repealed.

Asked about the role and purpose of organized medicine and about what the School of Population Health will mean to local physicians, Nash says of the former that it's largely a circle the wagons effort in self protection. So far as local physicians are concerned, he says “I hope they'll view us as a source of unbiased and usable information.”

David is married to Esther, who is VP for a Plymouth meeting-based healthcare advocacy company. They have twin daughters aged 27 and son of 23. When not adding to his voluminous 127 page curriculum vitae, he plays tennis, rides his bike and practices yoga.

After some 25 years at Jefferson, David Nash is contemplating writing at least one more book … perhaps a memoir in which much of what you read here will be expanded in volume and perhaps even in value.

In sum, David has the energy, intellect and leadership skills to take his troops into the battle for improving Philadelphia’s – and the nation’s – population health.