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A Health Care ‘Rock Star’

In April, I had the pleasure to meet and host a health care ‘rock star’ in my office, Rosemary Gibson. Rosemary is a Senior Advisor at The Hastings Center, an Rock-star“independent, non-partisan, non-profit bioethics research institute” based in New York.

In addition to having a very impressive and powerful resume, Rosemary has written four books that provide critical insight into our health care system that is both disturbing and, quite frankly, outrageous. These extremely well-written books are co-authored by, Janardan Prasad Singh, an economist at the World Bank. After meeting with Rosemary, I quickly purchased all four books and challenged myself to find time to devour them in short order.

Rosemary Gibson’s books include:

  1. Wall of Silence: The Untold Story of the Medical Mistakes That Kill and Injure Millions of Americans.
  2. The Treatment Trap: How the Overuse of Medical Care is Wrecking Your Health and What You Can Do to Prevent It.
  3. Medicare Meltdown: How Wall Street and Washington are Ruining Medicare and How to Fix It.
  4. The Battle Over Health Care: What Obama’s Reform Means for America’s Future.

Using her extensive knowledge, Rosemary passionately speaks the unmitigated truth about a very complex and perverse health care ‘system’ in which we all participate. As an example, Rosemary shared with me this-alarming (if not mortifying) fact about health care spending in the U.S. that was generated by the Congressional Budget Office (CBO):

“If historical health care spending trends continue, the U.S. will be spending 99 percent of its Gross Domestic Product on health care by 2082.” That’s right – 99 percent in about 68 years! (Source: CBO. The Long-Term Outlook for Health Care Spending. Appendix D. November 2007).

Our country currently spends about 18 percent of our GDP on health care, which makes it nearly one-sixth of our existing economy. If accurate, the CBO estimate would essentially mean our entire economy would consist of health care – which is absolutely astounding!

Granted, the CBO report was published in November 2007, about three years prior to the passage of the Affordable Care Act (ACA). Yet, many experts argue that the ACA was more about covering additional people under different types of health care plans (both public and private), than attempting to control the cost of health care.

Rosemary was greatly interested in our recently published white paper, ‘Voices for Value,’ on how Iowa employers view the health care provider community. 

I’m looking forward to finding new ways to collaborate with Rosemary in the future and welcome her expertise here in Iowa. Rosemary’s background and critical insight into our fractured health care system is greatly appreciated as we strive to find new opportunities to make a difference.

You will hear more about this health care ‘rock star’ in future blogs – stay tuned!

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A New Revolution Begins: ‘Voices for Value’

This is your world. Shape it or someone else will. Gary Lew

This quote is so true! If we simply sit back and complain about the status of healthcare and health insurance rates in Iowa, nothing will change. We need to reshape our healthcare world. And, to begin to shape it, we need an open and honest dialog about the conditions that currently exist, determine what is working and where improvement is needed.

To encourage this dialog, I have written a ‘Voices for Value’ white paper, based on employers’ responses to survey questions regarding their satisfaction with their regional hospitals and doctors. You may download your FREE copy of ‘Voices for Value‘ here. Since issuing our press release last week on Iowa employer perceptions of the Iowa healthcare provider community, the interest in this white paper has been overwhelming!

Iowa Association of Business and IndustryI wish to thank the Iowa Association of Business and Industry (ABI) for sponsoring ‘Voices for Value.’  After learning about this paper, ABI has been extremely supportive in promoting the contents of our survey. It is a great honor for me to have ABI involved as the sole sponsor. 

The findings from this ground-breaking survey are quite clear:  Iowa employers expect more from their healthcare providers than what they are currently receiving in most all of the survey’s 11 performance indicators.

  • Access to services
  • Concern for patient satisfaction
  • Electronic health records
  • Consistent quality of care
  • Ability to engage patients
  • Focus on wellness and health promotion
  • Efficiency
  • Coordination of care among providers
  • Transparency in medical outcomes
  • Cost transparency
  • Keeping cost reasonable

In addition to the above indicators, employers were asked to rate the extent of ‘Trust’ they have for the providers serving their workforce. Having trust in those who provide care is paramount to having a highly-functional healthcare system. I firmly believe that greater trust will result when improvements are made within each of the performance areas.

Until this survey was conducted in mid-2013, the voice of Iowa employers has been diffused, diluted and, mostly silent. For care to be appropriate, efficient and cost effective, a meaningful revolution must occur in Iowa (and elsewhere) to drive innovation with carefully-placed incentives (and disincentives) that will reward behaviors we desire – from both the care delivery and consumption sides. But it won’t be easy.

It has been said that “Revolutions never happen in comfortable shoes.” 

As found in most social change, this new revolution will be uncomfortable, but very necessary – if not critical. Healthcare providers must heed the voices that have emerged from ‘Voices for Value,’ and take action to deliver high-value care to their customers, the very people they serve within their communities. This revolution may also be uncomfortable for employers, who have historically relinquished the oversight of healthcare delivery to third parties. Now, employers must take action by providing constructive, ongoing feedback to the providers serving their communities. Somehow healthcare has lost this critical ‘voice’ to serve as a crucial guide on how care should be delivered.

The new healthcare revolution in Iowa is buoyed by ‘Voices for Value.’ However, Voices merely serves as the first step in a long journey to high-value care that we all deserve. The ‘value’ of care has been defined as health outcomes achieved per dollar spent* – and we currently spend an enormous amount of money with seemingly few controls to reduce this growing expenditure. Yet, as witnessed in our survey results, Iowa employers have spoken loud and clear that care is mediocre, at best. A revolution is necessary to reshape our healthcare world.

Based on how Iowa employers perceive the care provided within their communities, ‘Voices for Value’ establishes the basic framework of issues that require new transformations in our local healthcare system. ‘Voices for Value’ is not an exhaustive accounting of the myriad of issues inherent in healthcare, but rather, it serves as a baseline from which new initiatives can be thoughtfully developed and pursued by all interested stakeholders within Iowa to make the changes that we all desire to have.

Continue to follow our future blogs on how this revolution is gaining traction and, most importantly, how YOUR voice can be heard!

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*Michael E. Porter, Harvard Professor

Employer Perceptions on Healthcare System – a National Perspective

National Healthcare PerceptionsDeloitte Consulting develops thoughtful studies on nationwide employer practices, specifically relating to employee benefits and healthcare issues. Their 2013 Survey of Employers study is no exception. Results from this particular study provide a great framework to the findings we will be releasing in April.

Deloitte’s topic within this report? How employers perceive the healthcare system. Their findings are both interesting and concerning for all of us. I’m not surprised, nor should you be.

The cliff notes from this survey reveal the following:

  • Employers view the healthcare system as wasteful and expensive.
  • Keys to improving the system are increased transparency around pricing of specific medical products, services and procedures. In addition, employers want “clear, accessible information about the performance of care provided by doctors.”
  • Despite almost four years into implementation, employers still do not understand the features of the Affordable Care Act (ACA).
  • Only 22 percent believe the ACA will reduce costs by 2019, and just 19 percent think the law will improve quality-of-care during that time.
  • Only 33 percent of employers grade the performance of the healthcare system as “A” or “B.”
  • 38 percent rate our healthcare system a “C,” and 29 percent rate it a “D” or “F.”

The big takeaway is that employers are frustrated over a perceived lack of ‘value’ in the price they pay for health coverage. The healthcare system is underperforming in numerous ways.

Keep this topic in mind and visit our website in April, as we will be releasing Iowa-specific information that reveals employer perceptions on 11 different performance indicators, in addition to the ‘trust’ employers have in their hospitals and physicians. I will also be releasing a white paper titled, “Voices for Value: Iowa Employer Perceptions of the Iowa Healthcare Provider Community.”

Stay tuned as this topic will only gain greater traction over the next months and years to come.

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