Community Health Care

Written By: Edward Smith

Date: January 14, 2013

Change from the inside

 

Andy Warhol once lamented, “They always say time changes things, but you actually have to change them yourself.”  Indeed. Regardless of the pace of that change, it is worthwhile to document progress and reflect upon milestones passed. Most important, we should celebrate the creative risk-takers who build momentum toward more sustainable futures for their communities.
Across the nation, individuals and employers have endured decades of health care cost growth at four times the general inflation rate. Over the past five years, the average American has felt our national economic malaise in many ways – e.g., rising fuel and food costs, home equity loss, lay-offs, stagnant salaries – but the rising cost of health care has siphoned off four of every five dollars of household income growth. To balance budgets, employers have shifted more health costs to their employees, and it appears the federal government (and many states) have abandoned cost control efforts altogether.

Complex problems with multiple stakeholders require collaborative solutions that can generate recognizable value. This may be why the answers to unrelenting health care cost growth are more likely to come from market innovations than from Washington, or even from the nation’s major metropolitan centers.

Troup County, GA, with almost 70,000 people, lies about 50 miles southwest of Atlanta, just east of the Alabama border. Beautiful, with an eclectic fine arts scene, an emerging liberal arts college, a nationally recognized regional health system and efficient transportation access, Troup has attracted an impressive array of national and regional firms.

The most remarkable recent industrial addition occurred in the fall of 2006, when Kia Motors broke ground on its state-of-the-art North American manufacturing facility. The first Kia Sorrento rolled off the assembly line in the fall of 2009.

A quieter but similarly profound anniversary occurs here in the fall of 2012. A year ago, leaders of the Troup County government and LaGrange College collaborated with Orlando-based WeCare TLC to create a primary care clinic for their employees and families, and the college’s students. Then, last month, Kia Motors announced that it had awarded a contract for onsite occupational health services to West Georgia Health (WGH) and WeCare TLC.

What does this mean for our community? As our friends at Kia might implore, let’s look under the hood.

Evolved health care depends on a forward-thinking health provider with comprehensive diagnostic, specialty and inpatient services but, most importantly, an unwavering community focus. WGH, like other regional health systems, recognizes that, as health care payors move away from paying for services and toward paying for outcomes and value, its revenues and margins will likely be squeezed. At the same time, penalties will apply for excessive readmissions and other quality-based problems.

How can a health care provider sustain, much less grow, revenue under these conditions?  WGH has responded with a relentless drive for quality care and operational efficiencies, coupled with embracing innovative strategies designed to grow market share. Their efforts are paying off.  Recently Carechex, an independent health care information company, ranked WGH 3rd out of 114 Georgia facilities for medical excellence in overall hospital care.

Meanwhile, local employers are beyond frustrated with stratospheric employee health care costs. Every year, their advisors suggest new tricks – shifting costs, tweaking benefits, wellness programs, lifestyle coaching, renegotiating network discounts, generic/mail order drugs, biometric incentives – but costs only rise.  Employers are desperate for ways to apply proven business principles to managing care and cost. And they worry that government “fixes” will move the cost needle from excruciating to unbearable.  Candid and open dialogue between employers and providers produces meaningful results.

WeCare TLC, the clinic vendor, has developed a national reputation for improving the health of its clients’ employees and their families while driving down their health plan costs. While its operations are based in primary care, it uses a variety of medical management techniques that drive the appropriateness of care, positively influencing care and cost throughout the health system. In theory – and it appears to be playing out in reality – consistent application of these approaches produce dramatic cost reductions over time, especially relative to the health costs of other firms that have not implemented these steps.

An interesting question is what happens when, with an initial footprint of “pioneer” employers, this kind of health care collaboration, between aggressive medical management and an innovative health system, produces evidence of having reduced cost and improved health care quality?

Other employers, seeing the value, join the conversation. This creates a critical mass of patients.  Market forces begin to take hold.  Local provider market share grows, employer health care costs drop, and employees’ health improves. Regional employers become more competitive and prosperous. In addition to being healthier, the community becomes a more attractive location for expanding businesses.

We can already see the potential in our small Georgia community, and we’re pursuing it. But what we’re doing should be a reminder to business leaders everywhere. We are in a new era of health care, one that empowers creative risk-takers. Innovators who demonstrate value can come from and take root anywhere, solving old problems in new ways, and infusing vibrant new life into thoughtful communities.

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