Tuesday, September 4, 2012

BETTER HEALTHCARE, DECREASED COSTS: A MODEL WE CAN REPLICATE

A New  York Times editorial on September 3, cites the work of Bellin Health, a relatively small healthcare system in Green Bay, Wis., in managing healthcare costs. I was impressed by this piece for several reasons and wanted to bring it to your attention.
First, it is interesting that a relatively small hospital (178 beds) has managed to build a system of care capable of controlling costs and achieving extraordinary quality results. We usually hear about Geisinger and Kaiser Health Systems as achieving these results.  Yet here is a small provider marshalling the resources and the know-how to make a difference. It should inspire the rest of us to explore new ways of delivering care.
Second, it is interesting to see the tactics employed by Bellin to achieve those results. Bellin has employed a large number of primary care physicians and nurse practitioners to ensure that patients can be seen promptly. Their experience seems to confirm that a strong primary care base, combined with convenient and timely access, not only improves outcomes but reduces overall costs. This is not surprising as countries with higher ratio of primary care providers to population tend to have better health outcomes and lower costs.
"A strong primary care base, combined with convenient and timely access, not only improves outcomes but reduces overall costs."
Third, it seems that Bellin has been successful in working effectively with employers to lower their healthcare costs. The editorial notes that a number of companies have contracted with Bellin to provide on-site care to their employees. This encourages employees to seek care early and avoid expensive care in emergency departments. This information, I hope, will encourage more companies to partner with local healthcare systems to find innovative ways to reduce their healthcare expenses. In my experience companies are usually reluctant to make upfront investments even though they are crazed about their increased cost of health insurance.
As the CEO of a small healthcare system, I am sometimes overwhelmed by the challenge of converting from a traditional hospital-based system where volume is king to a system based on improving the health of the population while helping to control the costs of healthcare. Managing the transition from hospital buildings and state-of-the-art technology as capital to primary care physicians and nurse practitioners as capital, is incredibly challenging. In the midst of this transition, it is encouraging to hear about a system that seems to have made great strides in that evolution.
I look forward to your comments. —Lou Giancola

2 comments:

  1. Nice job- I liked the article as well. I think that the collaboration with employers is the key. They don't just do primary care- they do public health.

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  2. TED ALMON WROTE:

    Lou, I agree the challenge for a relatively small health system to become an ACO is rather daunting. I would suggest meeting in person with some employers in the South County area to explain the concept and gage their interest. You will also need either a partnership with an insurer in the State or a license to be an insurer, a la what Steward is doing in MA.

    I do believe SCH could put together the pieces of this puzzle and could provide very high quality care at below market costs. Whether you have the scale to satisfy all the employees in a given group will be the challenge. Why not start with SCH employees?

    I think if the insurance exchange allows you to go after individuals in the SC market, you will do quite well. As you know I favor a system where employers provide a voucher redeemable on the exchange to employees rather than one size fits all coverage as they do today. Good luck. TA

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