Our Ailing Healthcare System
More than 100 area business leaders attended a recent forum that looked at how we can provide better value from our healthcare system. Speakers were Dr. Keith Knepp, Methodist VP of Systems Integration, and Bill Leaver, president and CEO of Iowa Health System (IHS). Methodist has been a senior affiliate of IHS since 2011, and as a system, we are united under a common vision—to lead in care coordination and ensure the best outcome for every patient every time.
But what if our healthcare system itself is the patient? How do we achieve a better outcome for a system that is increasingly unsustainable economically? Just consider how U.S. healthcare spending compares to that of other developed countries. For each year of a patient’s life up to age 57, our expenditures are comparable to those of the United Kingdom, Germany, Spain and Sweden. But from age 57 on, U.S. healthcare expenses soar dramatically, and by age 85, we are spending four times as much per person per year. Yet all this spending does not produce results that are four times better. In fact, medical interventions at the end of life—no matter how well intended or executed—often do not improve quality of life and may actually have a negative impact.
How, then, do we fix this patient—our American healthcare system? We believe the answer lies in how we deliver care, what we expect from our healthcare system and how we pay for it. To begin with, we need to move away from the current fee-for-service system—which rewards volume, not quality or service—and adopt the principles of value-based performance. This approach may be the most important and transformative change brought about by the Affordable Care Act.
Already, Methodist and other IHS affiliates are changing the way care is delivered by looking at how hospitals, physicians and home care providers can work together. We believe that surrounding the patient with care that’s coordinated among those entities will result in better value overall, with “value” defined as the best outcomes and the best patient experience at the best price.
We are also moving from a hospital-centric system to a physician-driven model of care, with the patient at its center. One innovation underway is the development of medical homes in primary care physician offices. Office personnel are trained to play a more active role on the healthcare team so they can perform important non-medical tasks, like gathering information and reminding patients about flu shots and other routine health maintenance. That frees the doctor up to focus on managing complex health conditions and developing meaningful doctor-patient relationships. At the same time, registered nurses are being used in important new ways—for example, as care navigators who help patients manage their health, resulting in fewer hospitalizations and better quality of life.
It won’t be easy to fix our healthcare system, but we believe that care coordination is taking us in the right direction. Those patients who have already begun to experience this new model of care agree. And the best news for everyone is that the care patients want to receive is the care we want to provide—the reason we got into healthcare in the first place. iBi