As the stock markets head south, job creation remains moribund, consumer confidence slides, and the approval rating of Congress reaches a new historic low (that’s pretty darn low), the U.S. economy faces a daunting possibility of a double dip recession with no clear way to stimulate new growth and create jobs. Why don’t we seize this crisis as an opportunity to truly transform health care for the better? While it may seem counterintuitive (most meaningful system redesigns do), doing so could create significant numbers of good jobs here at home AND lower overall health care costs. Here’s how.
The most powerful transformative healing force in our health care system are the people working within it. Not EMR’s and their bits and bytes, but living, breathing, highly imperfect, dedicated, and passionate human beings. As important and as useful as Health IT is for helping people heal themselves and one another, and for improving the safety and reliability of care, it is still only a tool to help the healers. Not the source of healing itself. The nearly decade long experience of Health Quality Partners in the Medicare Coordinated Care Demonstration (MCCD) proves that we can improve health outcomes, create good paying new jobs, and lower overall health care costs.(1)
The most obvious opportunity for job growth is in developing the ranks of the the next generation of nurse care managers and primary care physicians. By targeting higher-risk chronically ill older adults to receive the kind of advanced community-based care management system designed by HQP, about 16% of the nations 48 million Americans on Medicare (about 7.7 million) could benefit – being given the chance for a better quality of life, fewer hospitalizations, and lower overall health care costs. Doing so could create over 100,000 new nursing jobs, thousands more administrative, IT, and other jobs, and strengthen the numbers and support the role of primary care physicians. We know through long-term population trials like MCCD that this can work. There is a great opportunity to innovate other variations of healer-driven team models (with several other disciplines included) to serve other vulnerable populations in their communities too.
There is no doubt that taking these new models of health care delivery to large scale and adapting them for local conditions while maintaining their effectiveness is a big challenge, but it is one that has clear and measurable performance parameters and about which we have already learned a great deal. Perhaps we can use our current crisis to force us to think differently and more courageously about transforming our health care delivery system. Not only through better use of bits and bytes, but through humans working together in new ways, in new roles, and using new skills and processes.