Following is a guest blog post by Dr. Paul Grundy
While the national debate on health care reform heats up, we’re seeing an area of common ground: the need to focus on wellness, prevention and primary care. Studies show that when someone has a comprehensive primary care provider as their usual source of care, their medical care costs one-third less and they have a 19 percent lower mortality rate.
If we increase prevention and wellness programs, we’ll reduce expensive emergency room care and free up doctors to spend more time with patients to keep them healthy — not over-treat conditions, which ratchets up costs.
I touched on this in a recent segment on BBC-TV. We need more physicians to take the initiative on health care reform through patient-centered primary care and prevention.
Doctors who embrace patient-centered care are spending more valuable time with patients, adopting electronic medical records to improve efficiency, and even consulting with patients after-hours via email to gain a full view of the patient, 24/7.
The notion of comprehensive primary physician-based care that creates a “medical home” has been proven to reduce a patient’s medical bills because it veers away from expensive, unnecessary medical tests and procedures. That’s more crucial than ever: according to a study published online by the American Journal of Medicine, 60 percent of all bankruptcies in the United States in 2007 were driven by health care costs.
We must work with physicians to build a comprehensive system of primary care and align this with how we pay them. Let’s learn from the truly successful examples. IBM employees who are patients at Kaiser Permanente are experiencing one-third less deaths from heart disease. And when they go for their eye glasses, someone will ask them about an overdue glaucoma screening exam — not about an unrelated procedure that is of little or no value to the patient.
Other places like Geisinger in Pennsylvania and Healthpartners in Minnesota are doing exciting things with a focus on primary care. At Geisinger a patient centered medical home model decreased hospitalizations by 48%. Healthpartners has pioneered nonpayment for treatment of preventable complications and they have focused on condition management at the point of care delivery.
Fixing the health care crisis is a huge task. We clearly want to have care for all, but in order to afford this, we need to focus like a laser on transforming the model of care itself and building upon the need for primary care and prevention. We need to accomplish real care management — at the point of care delivery — with the tools and technology to support primary care. That should be accomplished not in a physician-centric way, but in a patient-centered way with a total team approach, involving nurses, mental health providers, pharmacists, office staff and physicians.
As a large employer, IBM has 450,000 reasons to care about the national discussion about healthcare reform — counting employees, retirees and dependents, IBM spent. $1.3 billion on health care alone in 2008.
And as a country, we need to invest more in primary care doctors and incent them in line with the outcomes we want: better health. Only on this foundation can we build smarter healthcare that makes sense.
Dr. Paul Grundy is Director, Healthcare Transformation, IBM, and President of the Patient-Centered Primary Care Cooperative (www.pcpcc.net)