Lumetra Healthcare Solutions

On June 2^nd, Christina Romer, chair of President Obama’s Council of Economic Advisers wrote in a Yahoo!News op-ed, “Healthcare reform is more than a social imperative – it is an economic necessity.” Her op-ed was introducing a new study by the President’s Council of Economic Advisers entitled, The Economic Case for Health Care Reform. The study found what I think everyone in healthcare policy knows: the financial trends in our current healthcare system are not sustainable.

The December 2008 study by the McKinsey Global Institute, “Accounting for the Cost of U.S. Healthcare: A New Look At Why Americans Spend More,” found the United States spends $650 billion more on healthcare than expected. In addition, numerous other reports have concluded that, despite this overwhelming expenditure, our system produces poorer clinical outcomes when compared to other industrialized nations.

For the first time in a generation, there may be enough broad-based political will, driven by economic necessity, to fundamentally reform how our nation’s healthcare is financed and delivered. Momentum for reform has been building in Washington for much of the past year. It seems as if every advocacy organization, think tank, health policy expert, consulting shop, and trade associate is publishing a white paper or study on the subject.

One of the more thoughtful pieces to come out recently is from the Commonwealth Fund: The Path to a High Performance U.S. Health System: A 2020 Vision and the Policies to Pave the Way. The report’s authors propose a set of policies geared toward producing affordable health insurance along with payment and system reforms resulting in better access and improved population health.

It is expected that this summer the Congressional committees of jurisdiction in the House and the Senate will accelerate their work on legislation reforming the industry in which we all work. One of the best indicators of the options that will receive serious consideration can be found in the three policy options papers that the Senate Finance Committee has released during the past few months:

• Financing Comprehensive Healthcare Reform: Proposed Health System Savings and Revenue Options
• Transforming the Healthcare Delivery System: Proposals to Improve Patient Care and Reduce Healthcare Costs
• Expanding Healthcare Coverage: Proposals to Provide Affordable Coverage to All Americans

All of these policy papers can be downloaded in the Healthcare Reform Section of the Senate Finance Committee’s Web site.

There are so many ideas being bandied about that. As an interested observer, it’s hard to track them all, much less know which ones are worthy of support and how they will impact our respective healthcare business interests. That being said, I sincerely hope that one of the end results of the forthcoming reform is a much more patient-centric approach to healthcare, oriented around a Medical Home.

The Patient Centered Medical Home is a medical care office, center, or clinic that assigns a team of healthcare professionals to every patient. This team offers customized, coordinated, and comprehensive primary healthcare. Lumetra has been an advocate of this approach to healthcare since 2007 and recently endorsed the nine principles of the National Partnership for Women & Families designed to assist legislators, healthcare providers, employers, and insurance carriers consider consumer interests as delivery system reforms, including the ‘medical home,’ are developed.

The national partnership’s nine consumer principles:

1. In a patient centered medical home, an interdisciplinary team guides care in a continuous, accessible, comprehensive, and coordinated manner.
2. The patient centered medical home takes responsibility for coordinating its patients’ healthcare across care settings and services over time, in consultation and collaboration with the patient and family.
3. The patient has ready access to care.
4. The patient centered medical home “knows” its patients and provides care that is whole person oriented and consistent with a patient’s unique needs and preferences.
5. Patients and clinicians are partners in making treatment decisions.
6. Open communication between patients and the care team is encouraged and supported.
7. Patients and their caregivers are supported in managing the patient’s health.
8. The patient centered medical home fosters an environment of trust and respect.
9. The patient centered medical home provides care that is safe, timely, effective, efficient, equitable, patient-centered and family-focused.

Stay informed and stay engaged in healthcare reform. It is likely that the future of healthcare financing and delivery could very well hang in the balance.