Population Health Outcome Measurement Strategies for State Flex Programs

Document Type

Policy Brief

Publication Date



Population Health, MRHC, State Flex Program, outcome, evaluation


This brief on population health outcome measurement strategies for State Flex Programs (SFPs) targets an important need – the ability to monitor and document the impact of the Flex Program over time. This is an area in which SFPs have struggled for some time. This brief presents a framework that connects the activity categories under the population health program area into a strategic process within individual project years as well as across the project funding cycle. This framework consists of a series of steps that move sequentially from identifying the needs to be addressed, educational programing to prepare participants to engage in proposed interventions, development of shared learning collaboratives/cohorts to support performance improvement, and the implementation of interventions to address identified needs. It further provides practical examples of population health improvement activities with short, intermediate, and long-term outcomes necessary to document program impact over time. It also connects these activities through examples of a causal pathway with subsequent activities building on early activities to move toward desired long-term goals.


For more information on this report, please contact John Gale, john.gale@maine.edu.

This report was completed by the Flex Monitoring Team with funding from the Federal Office of Rural Health Policy (FORHP), Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services (HHS), under PHS Grant No. U27RH01080. The information, conclusions and opinions expressed in this document are those of the authors and no endorsement by FORHP, HRSA, or HHS is intended or should be inferred.

Funding Organization

HRSA-Federal Office of Rural Health Policy

Grant Number

PHS Grant No. U27RH01080