Rethinking Population Health: A Conversation with Dr. Brian Silverstein
Healthcare’s transformation toward value-based care has been in motion for years—but the pace has been slower than many expected. In the latest episode of Patient No Longer, Dr. Brian Silverstein, Chief Population Health Officer at Innovaccer, joins host Ryan Donohue to unpack why that’s the case—and what the future holds.
With decades of leadership experience and a deep understanding of healthcare governance, Dr. Silverstein offers an honest, practical look at the systemic challenges facing hospitals, patients, and policymakers today. Covering topics ranging from data blind spots to social determinants of health, his insights provide a roadmap for healthcare leaders looking to make meaningful change.
What Is Population Health, Really?
Although the term population health has become a buzzword, Dr. Silverstein reminds us that it’s more than a trend—it’s a philosophy.
“It’s a way of thinking about care differently,” he explains. “Instead of focusing only on the individual, it asks how we can segment groups and apply interventions that improve outcomes for the entire population.”
Despite its potential, widespread adoption of population health strategies has been slower than many predicted. Why? According to Dr. Silverstein, it’s not due to lack of interest—it’s about complexity.
Why Progress Has Been Slow
One of the biggest takeaways from the conversation is that healthcare’s transformation is being held back by real-world obstacles. Health systems are still heavily reliant on electronic health records (EHRs) not designed for population health management. Reimbursement models remain largely fee-for-service. And change management in large organizations is never simple.
“There’s no easy button,” Dr. Silverstein says. “Population health requires not just a shift in philosophy but in infrastructure, data, and behavior. And that takes time.”
The Role of Social Determinants of Health
A recurring theme in the episode is the essential connection between population health and social determinants of health (SDOH)—factors like housing, food access, transportation, and financial stability.
“When it comes to predicting health outcomes, historical utilization is a minority factor,” Dr. Silverstein notes. “What really drives outcomes are social determinants.”
For healthcare organizations, this raises an important question: If the most predictive factors aren’t clinical, why aren’t they part of our data dashboards? Dr. Silverstein acknowledges that while data on SDOH does exist, it’s not always accessible or standardized across populations. Still, it’s a gap that must be addressed if health systems want to truly improve outcomes.
Patients Want to Do the Right Thing
Dr. Silverstein also tackles a topic that often gets oversimplified: personal responsibility. In a healthcare system wrestling with chronic disease, noncompliance, and rising costs, it’s easy to blame the patient. But Dr. Silverstein offers a more empathetic and nuanced perspective.
“Most patients want to do the right thing,” he says. “If they don’t follow through, it’s usually because they don’t understand, or what they’re being told doesn’t align with their values or goals.”
This highlights the need for healthcare to take a more human-centered approach—one that connects clinical advice to what matters most in patients’ lives, such as playing with their grandkids or staying independent.
Understanding Local Markets Matters
Another important insight from the conversation is the importance of understanding local market dynamics. National healthcare trends can paint a misleading picture, especially when care delivery and reimbursement vary widely across regions.
For example, in some rural areas, hospitals are urgently pursuing new models to sustain local care. In others, especially where competition or employer influence is low, the pressure to change is less intense.
“There’s a lot of variation,” says Dr. Silverstein. “And the opportunity for healthcare leaders is to really understand their own market—not just follow the national trend.”
Disruption in Healthcare: Hype vs. Reality
The episode also takes a clear-eyed look at healthcare disruption. While tech and retail giants like Amazon, CVS, and Walmart have all made moves into healthcare, many have scaled back. Why?
Dr. Silverstein points out that disruption is much easier at the front end of care—in areas like urgent care, primary care, and virtual visits. But once you move into complex, ongoing care, he says, the traditional system remains deeply entrenched.
“Healthcare isn’t like other industries,” he says. “Until the payment and delivery systems change, true disruption will be limited.”
A Realistic Look Ahead
Looking to the future, Dr. Silverstein is cautiously optimistic. He believes we are at a low point in the journey, especially when it comes to how electronic systems impact physicians, but that better tools and processes are coming.
Still, his message to aspiring doctors and new healthcare professionals isn’t rooted in sugarcoating—it’s about finding purpose.
“Find your passion and joy and make it happen,” he advises.
Listen to the full episode with Dr. Silverstein, or watch the episode on YouTube.