A profoundly beneficial and economical approach to healthcare is being built in the Valley and every one of us has a role to play.
That’s my take-away from the presentation at the Wenatchee Rotary Club by Peter Rutherford, MD and CEO of the Wenatchee Valley Medical Center. His message describes the changes we should see in in our region’s healthcare.
He began by saying, “Healthcare is the right of every American. We have decided that as a country and I think that’s correct, but we have to recognize there is cost and somebody has to pay that cost.” He added WVMC also believes, and has data to prove it, that high quality care is less expensive in the long run.
He delivered good news. Washington costs are in the bottom quartile for Medicare beneficiaries in the country. We have opportunities to deliver better medical care at lower costs through the Confluence Medical center, the union of Central Washington Hospital and WVMC. “Our rationale for what we have been doing is to try to build a system here with local input and local control for absolutely as long as we can, and give us as physicians’ control of our own destiny.”
Going forward he believes the healthcare industry must change and the community must look at health care differently. For example we need to define quantifiable outcomes for healthcare, which he defined as improving health and the quality of life, or at the minimum reduce suffering.
He sees opportunities to control costs because 43 percent of medical costs are for hospital care and ten percent of the patients make up 65 percent of the cost. “I will argue that a lot of times people end up in the hospital due to their chronic disease because we didn’t do something right between the providers and the patient in the outpatient environment. That is frustrating for the patient, but it is also frustrating for us as physicians.”
His organization is studying the flow of patients through regional healthcare systems. “Where is the right place to provide care, the right time, the right way, and so on? We need to look at care in the home, in the outpatient environment, in the hospital if necessary, and then afterward to keep people out of that high expense setting. That’s what we’re trying to build with the Confluence Center, to try to get rid of this inpatient, outpatient silo.”
The regional concept has three phases: community based care, hospital care and recovery and rehabilitation. An example of improving community based care is the new four-year contract between Douglas County Hospital District #2 and WVMC to provide a Physician’s Assistant and medical dispensary in Waterville.
The community must look at health differently to recognize the integral relationship of health with mental health providers, health clubs, social service agencies and education. For example the social problem of homelessness has an impact on medical resources.
Individuals need to follow medical advice, especially when diagnosed with chronic diseases. Rutherford said the “Top five diagnoses are mood disorder, diabetes, coronary heart disease, asthma and hypertension.” When those patients seek and accept proper care and recommended treatments, they significantly reduce the likelihood they’ll need hospitalization. People should also embrace the healthy habits regarding nutrition, lower weight, not smoking, and limiting alcohol consumption.
Employers should study where they spend their health care dollars, especially if they’re self-insured. They should identify ways they can incent employees to get treatment early. They might offer Health Savings Accounts to employees. Insurance company Premara told Rutherford they’ve seen a 25 percent reduction in costs where employees have HSA accounts.
WVMC has signed an agreement with Premera to share cost savings from innovative quality of care contracts. When WVMC’s systems care cuts insurance costs, WVMC shares in the savings. He believes Medicare and the Affordable Care Act must shift from paying fees for services to paying for the quality of healthcare.
The community needs to understand the healthcare industry must change and the community must assist in empowering those changes.
He told me, “The community has to start talking about it.”