Hackensack Meridian CEO: Even in a pandemic, let's keep focused on innovating healthcare

COVID-19 cases are waning throughout the nation. Hospitalizations are down. Mask mandates are being lifted. While we prepare for the pandemic’s next phase, let's also use this time to recommit to transforming healthcare and even accelerating the pace of innovation.

There's no question that two years of battling COVID-19 has affirmed the fault lines that we see in American healthcare: inadequate primary care; not enough focus on prevention and maintaining health; unequal access to care; limited options for mental health and addiction treatment and so on. 

Think of how different outcomes would be in future pandemics if people were healthier. Go even further and imagine a world where your ZIP code is not an indicator of your health. Imagine the day when there are no differences in outcomes based on race or ethnicity. We can't let COVID or other health emergencies distract us from our vision to build healthier and more resilient communities. 

First, the good news. Health systems throughout the nation are expanding access to care, making it more convenient and extending the reach into underserved communities. Consider telehealth. Virtual visits increased 38 times compared to engagement prior to the pandemic. Investment from venture capital in telehealth and other remote care delivery access has tripled in recent years and will continue to drive major expansion, as will evolving reimbursement models.

Beyond expanding telehealth, our network is one of many extending our ambulatory footprint deeper into communities. These facilities, many opening in repurposed retail centers, will be the front door to quality health care for more people. We are adding five health and wellness centers throughout New Jersey this year, joining 500 other patient care locations.

Additionally, a program launched in the pandemic to expand access to care and to open beds in crowded hospitals is growing: hospital-at-home. This is the kind of innovation that will really transform care. We launched a Medicare pilot for the program this month, but the real promise is scaling this approach with commercial payers and creating shared savings models to benefit payers and providers. Most importantly, CMS reports that outcomes improve and patient satisfaction increases and more underserved patients can access care. It's a win for all!

Second, there's no path to improve healthcare without significant investment in social determinants of health strategies. Healthcare must move from acute episodic care to an integrated and coordinated system focused on prevention and better care management. The pandemic was especially cruel to Americans with diabetes, obesity, and other chronic and costly illnesses. It impacted communities of color much more dramatically than white communities. 

Again, many networks are moving in the right direction, but more needs to be done. There are national leaders with impressive results. Kaiser Permanente has invested more than $41 million to build and preserve affordable housing for low-income residents. Our network is partnering with Now Pow, a digital platform that has helped us identify more than 250,000 people at high-risk and connect more than 52,000 of them directly with social services for rental assistance, groceries and more. I look forward to the day when this innovation is the norm throughout the nation.

Third, behavioral health care in this nation is at a crisis point. We need to urgently provide more access, more coordinated care, and innovate treatment. More than 47,000 Americans took their lives in 2019, a national record, according to the CDC. Suicide rates increased 33 percent from 1999 to 2019. And for children, the stats are even more staggering. The demand for pediatric behavioral health visits increased by 90 percent throughout our health network in the last two years. 

We determined the best way to write a new narrative for behavioral health was to partner with a leading provider, Carrier Clinic. Since our merger in 2019, we have made major strides: we opened an addiction treatment center; opened one of the first behavioral health urgent care centers in the nation; and reorganized acute mental health care in our network, transforming a community hospital into a regional hub for behavioral health care. 

Fourth, the nation must invest more in public health. Imagine a highly coordinated response from states and the federal government in which there were no shortages of vital supplies or long waits for tests. The CDC's budget fell by 10 percent from 2010 to 2019, according to Trust for America's Health. Testifying before Congress at the start of the pandemic, then CDC Director Robert Redfield, MD, said: "There's not enough equipment, there are not enough people, there's not enough internal capacity.'' We must do better. This investment should be strategic and coordinated between government, providers and payers to respond more effectively to public health emergencies. 

As healthcare leaders, our teams and communities depend on us to not only deliver in challenging times but to keep focused on building a better health system for the future. COVID-19 has tested us like never before and will continue to command our energy and focus. Let's make sure we never surrender our vision. As Steve Jobs said: "You have to be burning with an idea, or a problem, or a wrong you want to right. If you're not passionate enough from the start, you'll never stick it out.''

Robert C. Garrett, FACHE, is CEO of Hackensack Meridian Health, New Jersey's largest health network with 17 hospitals, more than 500 patient care locations and a school of medicine.

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