Zeke Emanuel — a senior fellow at the Center for American Progress — addressed the Doctors For America’s 2012 National Leader Conference Monday morning and urged physicians to remain engaged in the nation’s health care debate. Emanuel predicted that the Affordable Care Act will succeed in expanding coverage and slowing the growth of health care spending by 2020, but stressed that the biggest changes will occur in how health care providers deliver services to patients — an area which doctors must lead in shaping, he maintained.
Health care systems around the country are already moving away from the existing fee-for-service reimbursment system and coordinating care in a way that improves efficiency and care quality. These successes contain valuable lessons for the kind of delivery reforms the ACA hopes to foster and offer a glimpse into the system of the future. Emanuel explained what those changes will look like, relying on the real-world experiences of Group Health of Puget Sound in Washington state:
1) “It doesn’t look like lone doctors working alone. It looks like health care teams of doctors working with nurses, working with public health professionals.” Specialized groups of providers are better equiped to provide personalized care to patients with multiple chronic conditions, who consume two-thirds of the health care dollars.
2)”You don’t wait for the patient to come to you. You have active outreach to patients.” Providers track their pateints’ physiological indicators and call them to ensure that they’re complying with medication and other interventions.
3) “You have electronic health records so you can track patients over time … so that you can track physician, nurse and other quality performance in your group.”
4) “You also don’t treat patients individually. You have team huddles, you have team plans. You standardize care for patients.”
5) “You also create specialized clinics for chronic problems, have the best people you have doing that over and over.”
The results have been impressive. Sine adopting the changes, Group Health experienced a six percent drop in readmissions, a six percent decrease in length of stay, decreases in physician visits, but a dramatic increase in telephone calls and email communications. Most remarkably, the new system saved $1.50 for every $1.00 invested in the re-engering process over a 21-month period.
Providers also experienced a boost in morale “because the health staff finally felt like they were practicing the medicine they were trained to and not just doctor reimbursment,” Emanuel stressed.
That’s the future providers can look forward to. And now, they have to work to make sure it becomes a reality.