Health care: Seeking solutions through ‘community managed care’
By Bill Settlemyer
Executive Publisher
For the past three years, I have spent a good deal of my personal time focusing on health care issues. In 2003, the Business Journal began convening an informal discussion group, followed by two health care forums, one in 2003 and another in 2004. Several hundred business people attended the forums, along with experts from state government, health care organizations, employers and the insurance industry.
Starting in 2001, I began writing a series of columns on health care issues. The column you are now reading is the first such column since last summer, but that does not mean that I have stopped paying attention to the issues in the interim.
I am pleased to report that a number of recent developments hold some promise for progress in improving the quality and affordability of health care as well as the overall health of citizens in the Charleston region.
United Way steps up to the plate
In 2004, Trident United Way’s executive director, Chris Kerrigan, asked if I would combine the efforts of our Business Journal discussion group into United Way’s Promoting Health and Wellness Vision Council.
I saw the invitation as a great opportunity. Trident United Way’s volunteer board is a cross-section of the region’s top business and civic leaders, and I could imagine no better platform for launching an ambitious effort to improve the health of people in the Lowcountry.
In March, Trident United Way hired a full-time staff person to serve as the organization’s Health and Wellness Coordinator. With a full-time employee on board to implement and coordinate efforts, we are in a position to develop more sustained and effective initiatives on health and wellness issues.
The rallying cry is “Your Health Matters,” and the first initiative will be directed toward motivating people to improve their diets and become more physically active, not only for weight management but also because good nutrition and exercise have a tremendous number of health benefits.
A team effort
Trident United Way’s initiative is designed to be a team effort involving the entire tri-county community. The goal is to support health-related programs offered by other area nonprofits and to ask leaders in other sectors of the community—schools, churches, government, employers and health care providers—to adopt policies and practices that promote the health and wellness of those citizens they can best reach.
Information is also a key part of this initiative. Visit the Trident United Way Web site (www.tuw.org) and click on the “Promoting Health and Wellness” graphic for useful tools and information that will help you adopt and maintain healthy living habits.
How important is this effort? How important is it to reduce the region’s above average incidence of diseases like stroke, heart attack and diabetes? How important is it to reduce the incidence of expensive acute hospital care for diseases that might have been prevented or at least managed with less expensive care? How important is it for all area employers to have healthier and more productive employees?
I hope your answer to these questions is “very important” because that is the right answer.
When a plan comes together
There are other recent developments that offer promise in terms of improving health care, addressing the rising cost of health coverage and the plight of the medically uninsured in our region.
A few months ago, I was contacted by the executive director of the largest association of physicians in the region. The leadership of that group is proposing to use an electronic “clinical data repository” as a means of sharing critical patient information among primary care physicians and specialists. The goal is to significantly improve patient care through a combination of health risk profiling, sharing of appropriate medical records and access to “best practices” guidance from a sophisticated patient care database.
These steps alone would be a significant development, but there is more. A new health insurance carrier planning to enter the Charleston market has offered to work in collaboration with physicians, employers and hospitals in support of efforts to reduce costs through better care and shared claims data. This approach will help all the stakeholders to assess their progress in improving the health and wellness of the insured population.
The details are more than I can cover here, and there are many challenges that must be met along the way. But one thing is certain: These developments create an opportunity for us to seize the initiative at the local level with regard to the critical issues surrounding health care.
Community managed care
My label for the model we are developing is “community managed care,” which literally means that our entire community will share responsibility for managing health care. Citizens will be responsible for adopting healthier lifestyles and seeking appropriate preventive health screenings and treatment as needed. Employers will be responsible for giving their employees the tools and incentives to manage their own care better and make the best possible choices when purchasing health care services.
Physicians will improve their ability to play the critical role they should in patient care, starting with a greater focus on wellness and prevention. Better communication at the community level between employers, physicians, hospitals and other health care providers will increase the likelihood of collaboration designed to produce win-win outcomes for all concerned.
In my view, this is a vision for a better future for our region. To the extent we can realize this vision, we will be increasing our competitiveness, both as individual employers and as a region. Likewise, we will be better positioned to grapple with the vexing issues of the cost and quality of care for insured patients and the cost-shifted burden of uninsured care that distorts and conceals the true cost to the community of failing to provide some minimum level of care for all our citizens.
This effort will be a marathon, not a sprint. But however long it takes, it is a race we must win.
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