Access HealthColumbus

Advancing Patient-Centered Medical Home Innovation

2010-02-22T09:54:00.001-05:00

Advanced primary care models, like patient-centered medical homes, can provide the coordination mechanisms and decision support to improve quality, cost, and satisfaction.

Advancing Patient-Centered Medical Home Innovation

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2009 Our National Struggle for Health Care Reform in America

2009-10-28T22:58:00.001-04:00

Check out this SlideShare Presentation:

2009 Our National Struggle for Health Care Reform in America

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Health care debate's language needs clarification for electorate

2009-08-06T10:33:00.000-04:00

As negotiations continue on reforming our healthcare
system, it is more important than ever to ensure
we have clarity on key policy terms - especially some of
the most politically loaded terms: universal health care,
single-payer health care and socialized health care.
Some news reports inaccurately use these terms.

Universal health care should describe a system of
organizing benefits. It means to establish a "floor" of
benefits that all people have a right to access. People in
a universal health-care system can purchase benefits
above the floor. There does not have to be a ceiling.

Universal health care can parallel the universal education
system we have in this country. All people have
a right to access K-12 education. Parents can send their
children to public schools or purchase private education.
Given the acceptance of our universal education
system, universal health care should not be viewed as
an enemy of the liberty we enjoy in this country.

Single-payer health care means the centralization of
payment for health-care services from one organization,
such as the government. We already use a singlepayer
system for large parts of our health-care system
(Medicaid, Medicare and Veterans Administration
programs).

Socialized medicine means health-care providers are
employees of the government. We already have socialized
medicine, such as in the VA health-care system.
Universal health care does not require a single-payer
approach, nor does it require socialized medicine.

We need to understand these terms to improve the
health-care debate and policies so that we can compete
in a global economy and for the sake of our children.

Democracy hinges upon an informed electorate.

Fresh Ideas for Chronic Disease Prevention

2009-02-21T11:56:00.001-05:00

Increased chronic disease is eroding the health of our nation and community. According to the Centers for Disease and Prevention, over 45% of the U.S. population has at least one chronic disease. Chronic disease is responsible for seven out of every 10 deaths in the U.S., killing more than 1.7 million Americans every year (over 4,500 per day). People with chronic disease are the most frequent users of health care services, accounting for 81% of all hospital admissions, 91% of all prescriptions filled, and 76% of all physician visits. Overall, people with chronic conditions account for 83% of all health care spending in the U.S.

The Milken Institute (2007) analyzed the tangible costs of chronic illness to the U.S. and to individual states. Seven categories of chronic disease were considered: cancer (all types), diabetes, hypertension, stroke, heart disease, pulmonary conditions, and mental disorders. In Ohio, the direct cost to treat these seven categories of disease totals more than $13.5 billion annually. These conditions led to lost workdays (“absenteeism”) and lower employee productivity (“presenteeism”), resulting in another $43.4 billion in economic loss in 2003.

What should our community do to reverse this epidemic?
We can’t continue to ONLY pour more money (that we don’t have) into expanding health care delivery that treats chronic disease downstream. What we need is a commitment to explore innovative ideas that focus on upstream solutions!

Resources such as the Robert Wood Johnson Foundation Commission to Build a Healthier America (commissiononhealth.org) can help inform our local public policy to promote health by encouraging healthy behaviors and making it easier to adopt and maintain them.

One way to practice this is to integrate a HEALTH perspective into our public policy decisions, such as:

- Nutrition: Should we explore the VALUE PROPOSITION of making healthy foods more affordable and junk food more expensive as an investment in our health?

- Safety: Should we explore the VALUE PROPOSITION of increasing safety in our neighborhoods as an investment in our health?

- Exercise: Should we explore the VALUE PROPOSITION of providing sidewalks and green space in all neighborhoods as an investment in our health?

No doubt these issues (and others) will be tough public policies to address. However, if we do not make a stronger commitment to integrate a HEALTH perspective in our public policy decisions, we will continue to get more of what we got.

The first wealth is health

2008-12-18T07:09:00.000-05:00

We understand that our community and country are facing an extraordinary economic situation. Many organizations are attempting to find solutions to an increase in demand for services and scarce supply of funding.

While short-term budgetary decisions must be made, we should consider the long-term impact of these decisions on the health and wealth of our community.

What we know from our collaborative work in the community is:

• When people lose access to affordable primary and preventative care services, people will delay seeking care -- and their health declines.

• When a person’s health situation worsens and begins to impact their ability to work or be a responsible parent, they are faced with the need to seek primary care services. If timely access is not available, people go to emergency rooms for non-urgent reasons.

For example: Our best estimate is that in 2007 an additional $40 million in payments was spent in our community for non-urgent health care services provided in the emergency department, when compared to those same services being provided in a primary care center.

• When people receive non-emergency services in emergency rooms, it adds to the hidden cost of health care to those with health care insurance coverage.

For example: at least $1,000 of an average family’s health insurance premium is required to offset the hidden costs of our current health care situation.

The bottom line is the worst of both worlds occurs when people lack access to affordable primary care – people who need care are sicker and people with health insurance end up paying even more for the hidden costs.

Our community has worked collaboratively over the past few years to increase primary care capacity to serve an additional 20,000 people in our community. Yet we still have at least 71,000 people who lack a regular source of health care.

We should avoid reductions in local funding for primary and preventative care – the outcomes are sicker citizens and higher costs to the community.

During challenging times like we are currently facing, its hard to make needed investments for a better future. Health care serves both current and long-term needs.

Ralph Waldo Emerson once stated, “The first wealth is health.” The return on investing in primary and preventative care can be measured in both the health of people right now as well as the economic health of our community in the future.

Great opportunities disguised as insoluble problems

2008-11-22T14:50:00.003-05:00

The election is over. Excited winners now face limited resources to deliver on their campaign promises. Health care was on everyone’s list of important campaign issues. And we all know that money is scarce -- with our economy slow and a crisis in our financial system.

Conversations about reforming health care should not automatically begin with “how do we find more money?” Our national health care spending is already twice that of every other developed country in the world.

Our many complex health care challenges seem overwhelming. It is difficult to know where to start. Yet public-private partnerships from across our country have begun to build collaborative efforts to look for ways to use what we already expect to spend and see if we can increase value for those dollars.

Access HealthColumbus and its public-private partners are leading these efforts in central Ohio. We believe that public-private partnerships, such as Access HealthColumbus, are by no means a substitute for state or national reform. However, we are working with our partners to test and evaluate local innovative solutions to the health care problems we are facing in our country.

Consider these two initiatives as a good place to start:

Patient-Centered Medical Homes.

Not a physical place, but rather a physician-oriented team providing continuous and coordinated care, helping patients navigate our fractured, health care system. A few dozen communities have pilot projects testing and measuring the ability of coordinated care teams to deliver cost savings, better health outcomes, and higher patient satisfaction. And they are seeing success. Central Ohio is joining these efforts. Access HealthColumbus is creating a demonstration project for our community to adapt Patient-Centered Medical Homes to our local health systems.

Electronic Health Records.

Accurate health information, shared by care professionals saves money, improves health outcomes and gives higher patient satisfaction. While some good efforts have begun, our community’s efforts need coordination to make sure that all patients can move between our many excellent public and private health care providers. Access HealthColumbus is creating a demonstration project, with physicians and health systems, to develop an efficient method for sharing health information across systems of care in our community.

Health care is complex. The challenges are many. Each community is different. No one patient, physician, hospital or other health care provider is responsible for America’s health care ‘situation.’

Insoluble? We think not.

A wise person once said to look for “great opportunities disguised as insoluble problems.” We look working with our public-private partners on improving health care by advancing innovative solutions in our community.

We welcome your comments and suggestions.

Will the expansion of health care technology save a lot of money?

2008-11-03T09:11:00.001-05:00

The complexity of advancing health information technology in our $2 trillion health care industry is significant. While the issue of savings is vital, it is important to review ALL potential benefits of investing in health information technology.

Health information technology has the potential to:

a) improve quality of care,

b) improve patient safety,

c) decrease health disparities,

d) provide an efficient source of data for reform initiatives such as pay-for-performance and health care outcomes research.

Health care expenditures currently total over $8 billion in Franklin County (Ohio) alone, and will double over the next ten years based on current trends. Health care is becoming unaffordable for consumers and unsustainable for our society as we compete in a global economy.

If we are to bend the inflationary curve on health care expenditures, we will need access to better administrative and clinical data. We need to communicate VALUE (value = quality/cost) to consumers and purchasers in order to reform our current health care situation. Without investment in health information technology, we will continue to struggle with measuring the value of our health care expenditures.