The Department of Population Health is a strategic partner embedded across UVA Health, supporting patients, care teams, and communities throughout the Commonwealth. Our work is central to improving patient outcomes, optimizing hospital capacity, and delivering high-value care across the continuum.
We design and implement scalable programs that address chronic disease management, care coordination, and access to primary and specialty services. Our teams focus on delivering care beyond hospital walls—across inpatient, ambulatory, emergency, and community settings—to reduce avoidable utilization, support safe transitions, and improve continuity of care.
We are committed to ensuring every patient receives the highest quality care experience—grounded in safety, clinical excellence, and partnership—as we work together to achieve meaningful health outcomes.
Our services include:
- Complex care management and transitional care
- Innovative technology to track patient vitals in real time and proactive care coordination
- Mobile care delivery and in-home primary care
- Pharmacy consultation and medication reconciliation
- Community paramedicine services that extend clinical care into the home
- Behavioral health support for eligible patients
- Community health worker integration and clinical escalation pathways
- Comprehensive home health services delivering skilled nursing, therapy, and care coordination
Our approach is grounded in data-driven workflows, best practices, and close collaboration with providers and operational leaders. We support the organization’s mission by improving the patient experience, reducing unnecessary utilization, and advancing quality and safety.
Population Health plays a key role in helping UVA Health achieve its system-wide goals, including patient progression, readmission reduction, length of stay, the behavioral utilization of services, and sustainable growth.
UVA Health: Delivering Excellence Across Virginia
UVA Health is an integrated academic health system that delivers high-acuity, high-quality care throughout the Commonwealth. Our system includes a nationally ranked academic medical center with a Level I trauma center, a Level IV NICU, Virginia’s first NCI-designated Comprehensive Cancer Center, and UVA Health Children’s—the top-ranked pediatric hospital in the state.
The health system also comprises three community hospitals, a specialty rehabilitation hospital, and an extensive network of primary and specialty care clinics that serve both urban and rural communities.
Our Guiding Principles
- Center our work around the needs of patients
- Support and empower one another as a unified team
- Pursue excellence across clinical care, research, and education
- Make transparent, data-informed decisions aligned with our long-term goals
- Deliver the highest quality care with a focus on safety and an exceptional patient care experience
- Embrace innovation and continuous learning
- Steward our financial, environmental, and organizational resources responsibly
- Define clear objectives, measure progress, and celebrate success
- Strengthen UVA Health’s presence and trust across the communities we serve
UVA Health - Population Health Department
Phone: 434.243.6388 | Secure Fax: 434.244.9433
Email: populationhealth@uvahealth.org
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