Health Care Reform is easy…isn’t it?

Aug 26th, 2010 | by OurHealthCareSource.com

Earlier this summer, our company hosted a retreat which included two national speakers– Dr. David M. Cutler and Thomas Dehner, JD. We invited these leading health care experts to meet with us because of their insights into health care reform, and the transformation that is currently taking place in this industry.

A little background on Dr. Cutler – he is a Harvard professor, and he served on the economic council during the Clinton years. More recently, he was senior health care advisor to President Obama. And, he is intimately involved in strategies around financing health care in our country. So his points of view were particularly eye-opening.

As the Massachusetts Medicaid director, Thomas Dehner led efforts related to the Medicaid components of the Massachusetts Health Care Reform Law. Now a principal with Health Management Associates, Inc., his viewpoints on lessons learned and future implications were also very enlightening.

There was a point in the presentation where Dr. Cutler gauged the difficulty for the health care industry to convert. He proclaimed the following:

• Insurance reform is easy
• Coverage expansion is more difficult (he called it Medium)
• Improving the value of care is the most difficult (or Hard)

It was an interesting assessment, and it sparked a lot of conversation.

Insurance Reform is Easy
First off, none of what needs to happen within the health care system is easy to change. But what makes insurance reform “easier” than transforming other aspects of the health care system is because insurance reform relies heavily on policy and laws. The introduction of federal policy allowing parents to keep their children on their health plan until age 26 is a perfect example of how policy can quickly affect immediate change.

Coverage Expansion is Medium
Expanding health coverage to more Americans is certainly a more difficult goal to achieve. Two reasons expansion is harder:

1. The exchange could create a mass rush to the health care “storefront”. People who have not had access to health care will now be eligible, and that may empower a lot of people to act. How will our system react?
2. At the same time, it’s also difficult to get people to enroll. Dehner said this is “a close-to-impossible job” despite the federal dollars set aside for outreach. Communication and promotion will be the key to educating the public about the availability to get coverage. But even with substantial outreach, there will be plenty of people that are eligible for public health care programs and subsidies, but just won’t know it or don’t recognize ongoing health coverage as a priority. So finding these people and getting them into the system presents a challenge.

Improving the Value of Care is Hard
This is by far the most difficult area to transform—but not impossible. All players within the health care arena are being pressured to find ways to reduce cost while increasing quality…and that can sometimes appear to be an oxymoron. But we are already seeing solutions that will help move this goal along:

• Technology
  The more we integrate technology into the health care system – and that includes technology that provides information, not just devices – the better coordinated the system will be, and the better doctors will be at providing the right kind of care at the right time and place.
• Case Management/Coordination
  What case management and health care coordination does is put prevention and wellness at the center of caring for patients. By integrating case managers more into the system, patients, providers and insurance companies can be held more accountable, helping increase quality of care. Also, case management ensures that patients are using the health care system responsibly, and that lowers cost.
• Streamlining Administrative Duties
  It’s estimated that highly trained registered nurses spend one-third of their time charting patient status and there are more administrative personnel on staff than nurses. That’s a lot of resources being devoted to what could be considered “lost productivity.” The industry needs to continue pursuing automation and streamlining this aspect of the business-side of health care.

Hard, Harder, Hardest – But Worth the Pursuit
There are many challenges ahead for this industry. But so much progress has already been made in a very short time. As long as the players within the health care industry continue to collaborate, we will reach our goal. And once we’ve reached our destination as an industry, we’ll look back and understand that the pursuit was worth it. Because we’ll all eventually benefit from the transformation of health care.

What do you think are the hardest aspects of health care reform to further implement?