Healthcare leaders must live in today’s world and plan for tomorrow’s
We are in a historic time in healthcare. At hospitals and health systems across the country, we have spent years preparing for and provoking change. While the Patient Protection and Affordable Care Act serves as our current catalyst for change, the change imperative evolved long before the ACA was signed into law.
Times of historic challenge reveal the best in each of us and I believe there has never been a generation of healthcare leaders given an opportunity like we have today.
Each day in our organizations, we see talented professionals providing high-quality healthcare at reasonable cost. You also find the opposite— high-cost, lower-quality care and patients who fear the complexity of the system as much as their illness. We know that progress in specialization and technology has led to patients dealing with hundreds of caregivers, multiple locations and confusing billing systems. Often, the only common denominator is the patient.
At the same time, fewer patients need to visit hospitals, and they have shorter stays. Hospitals today are increasingly focusing on visits to physician offices, ambulatory imaging and surgical centers. A patient “visit” often looks more like Face Time on our iPhones than a face-to-face interaction in a doctor’s office.
Increasingly, hospitals in America are defining success as being more than a crane on their site and workers scurrying to build new patient towers with more inpatient beds. Progressive systems are investing in technology and ambulatory centers, and are reaching out to public health departments to patch holes in our healthcare safety net. We are in the midst of dramatic, unequivocal change. The very nature of healthcare delivery is being rapidly redefined.
This means healthcare leaders must live in today’s world and plan for tomorrow’s. And they are very different—one is built on the volume of services we provide. The other will be built on the value we offer patients.
We know that our healthcare system overspends on high technology and underspends on social, behavioral and environmental support for patients. For example, our fee-forservice system puts up barriers to diabetics who need routine foot care such as simply having their nails trimmed. But we pay generously to amputate that foot after lack of basic preventive care leads to severe consequences. Likewise, our system rewards back surgery, even though study after study shows that our undervalued physical therapy services can prevent most of those same surgeries.
Stories like these are too frequent and too painful. We must make them unacceptable. We can no longer afford even a single high-cost intervention for which there is unclear evidence of patient benefit.
In some countries, individuals see it as their patriotic duty to take responsibility for their health. Americans are as patriotic as anyone else and we love our freedom too. All too often, our freedom to choose has resulted in obesity, sedentary lifestyles, smoking and substance abuse. Our healthcare system cannot repair a lifetime of abuse or lack of attention to our own health and well-being.
So there is a giant equation at play. One person’s freedom to live an undisciplined life gets paid for by someone else, or increasingly, it directly deprives someone of life-saving treatment. And that just isn’t right. Engaging Americans in a serious discussion about their responsibility for their own health must be part of any solution set in healthcare.
Our healthcare field is an impressive laboratory for innovation and experimentation. Each day we experience pockets of brilliance. Committed boards, leadership teams and their organizations are seeing the changes in reimbursement as a superhighway to improvement and ultimately, making care better.
As more health systems transition from fee-for-service to models that share savings based on true value, the ingenuity of our industry is on display. We know of systems that are tailoring programs to elderly, chronically ill patients and improving their lives for a fraction of the cost. We know of communities that have banded together to address problems such as teen pregnancy or child abuse. We know of physician groups that have redesigned care for patients with lower back pain and reduced surgeries by 80% with happier, pain-free patients.
I am very optimistic about the future. No generation has a better opportunity than ours. Let’s take the best ideas from systems around the country to improve the patient experience, improve population health and reduce the cost of care. We must harness our potential and become an even more productive laboratory for innovation. Change is here. It is not slowing down. Neither should we.
James H. Hinton is board chairman of the American Hospital Association and president and CEO of Presbyterian Healthcare Services, Albuquerque.