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Changes in health care anticipated, needed

Health care, hospitals and reform have been front-page news, but the changes we’re seeing in health care shouldn’t be all that surprising. No matter on what side of the debate you land, most agree the system is unsustainable from a cost standpoint.

Our delivery system is loaded with perverse incentives that lead to care to being delivered in a very inefficient manner. The payment system rewards volume over value, is extremely complex to navigate, and is so weighed down by regulation and billing difficulties that providers in all areas spend an inordinate amount of staffing to cover billing and reporting versus direct patient care. For those with chronic conditions or suffering from long-term illnesses, the system incents the treatment of specific body parts rather than the treatment of the whole person.

Coordinated care, where health care is delivered by teams of health professionals, is what should be incentivized by payment. In such a model, data, prescriptions, test results, screenings and preventive directives are shared between the patient, physicians, pharmacists, therapists and anyone else involved in that person’s care. But it’s not simply technology like electronic medical records that will create coordinated care. It is all of us retraining ourselves and redesigning the system so that we work cooperatively.

We also need to focus on better health so that we need less health care. Challenging hospitals and other providers and ourselves as patients to make the lifestyle changes that keep us healthier will ultimately result in lower costs of care for us all. Preventive care, proper screenings and adopting healthier lifestyles are critical to avoiding physically and financially taxing conditions like heart disease and diabetes.

We also need to continue to embrace advances like telemedicine. Idaho hospitals that are integrating these systems into communities are allowing people in the remotest corners of Idaho to have the expertise of specialists in Boise, Seattle, Spokane or Utah without the cost and emotional burden of seeking care away from home. Less stress on patients, less travel and transportation, and appropriate care at the appropriate place benefit all of us.

Also key is a transition from providing care when you are sick to creating incentives and expectations for Idaho’s community hospitals to work at getting entire communities healthier.

There is a lot of movement in health care delivery, not only in the Treasure Valley, but also throughout Idaho and the rest of the country. Generally, it is directed toward making the system more efficient, with higher quality and lower cost. Hospitals and physicians are working together to care for patients more seamlessly and efficiently. Many communities are seeing new and expanded facilities to accomodate patient demands and improvements in technology.

This movement not only has been a long time coming, but it is also a necessity and would be occurring irrespective of the Affordable Care Act. No matter what the packaging is or what you name it, the changes we are seeing are for the benefit of the patients served by Idaho hospitals and physicians.


Steven Millard is president and CEO of the Idaho Hospital Association.

About Steve Millard