“When it comes to improving the nation’s health, there is still much to be done. Obesity has leveled off; however, it must remain a top priority, as 27.6 percent of adults nationwide report being obese. With rates of physical inactivity, smoking and diabetes at 22.9 percent, 19.6 percent and 9.7 percent, respectively, there is still considerable room for improvement in key health measures.”
In fact, the recent gains in smoking and obesity rates may be due more to popular public health campaigns (e.g., state funding from tobacco settlements for “stop smoking”
campaigns and First Lady Michelle Obama’s “Let’s Move!” campaign) than to proactive physicians engaging their patients in healthier lifestyles.
Healthcare providers want to keep patients healthy, but so far this desire hasn’t translated to significant gains in overall population health.
Why?
Any healthcare executive knows why. It’s because the financials don’t align with this model. While there is no doubt the tide is shifting, it’s happening slowly. Today, if a hospital-based health system successfully helped its patient population manage their chronic conditions, significant lowered smoking and obesity rates, and provided such great post-discharge care that no patient was unnecessarily readmitted, it would run itself out of business. Hospitals can’t change until the payment mechanisms catch up, and the responsibility for that lies with payers.
To make true gains, and do so quickly, payers must incentivize providers to manage population health, and then, boards must incentivize leaders to achieve real gains.
Within the last 5-10 years, patient experience has grown in importance among health system benchmarking and goal setting. Why? Because payers are tying payment to it, and, as a result, boards are tying executive compensation to it. When top leaders are paid to improve population health, I expect we’ll start seeing improvement. But first, providers must agree to take on the risk, and payers must agree to reimburse for it.
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