Five years have passed since the passage of President Barack Obama’s health care law, the Affordable Care Act, bringing some changes to health care that are embraced and others that are criticized. Still, many see opportunities to build on improving on the law, which was meant not only to cover more Americans with insurance but also to improve the care that is delivered.
Sunday at the U.S. News Hospital of Tomorrow conference in the nation’s capital, hospital executives discussed how the act has changed the way they do business and deliver care. They discussed the impacts of innovation, coverage and how to reduce waste in the system.
Dr. John Noseworthy, president and CEO for the Mayo Clinic, opened the conference with a keynote speech on “The Faces of High-Value Health Care: People and Processes.”
He highlighted a few ways the Mayo Clinic has better coordinated care, including the creation of “Ask Mayo Expert,” which allows patients to avoid a trip to the hospital by allowing them to connect with a health care professional online. “The patients that are coming are much more complex and need that tertiary care,” Noseworthy said. “It’s a win-win for everybody.”
Mayo also has invested in personalized, or genomic, medicine, putting information into patients medical records about how their bodies would react to certain medications. The result, he reported, is that the hospital has stopped 650 prescriptions that could have adverse outcomes.
He closed his speech by talking about staff burnout, which can come, in particular, as the health care system continues to heap demands onto providers. “Each of you have to care about the people with whom you work,” he said. “The hospital of the future will not stand by itself if we have a burned out workforce.” When hospital staff are burned out, they are emotionally exhausted and face a low sense of accomplishment.
Going off of the point about staff burnout was the executive roundtable “Transforming Health Care: Strategies for Tomorrow.” It included Noseworthy; Nancy Schlichting, CEO for Henry Ford Health System; and Warner Thomas, president and CEO of Ochsner Health System. Joanne Kenen, health care editor at POLITICO, moderated the conversation.
- To respond to burnout, Schlichting said leaders at Henry Ford Health System tries to bring staff together for conversations and support. “We always talk about taking care of the people who take care of people,” she said. “Many of our employees are caregivers in their personal life as well as at work.” Female staff members, in particular, she said, are caregivers to aging parents or sick children.
- Noseworthy said doctors have the types of jobs that naturally require hard work, and burnout is mostly a result of having difficulty finding purpose and meaning in work. Their lives are heavily impacted by the health care demands coming from the federal government. “They are data driven, they are good people, and they have to find meaning in their work and they want to be challenged,” he said.
- Thomas said from the patient side, an aspect they often find overwhelming is the enormous amount of data that appear in their records. “I think there is a realization that we’ve come to an overload situation,” he said. “Transparency is tremendously important but needs to be understandable by patients.”
- The Affordable Care Act also has had unintended consequences, executives said. Noseworthy said people are purchasing health insurance with a high deductible – the cost patients must take on before insurance picks up the rest of the tab – which can result in more debt for patients. “High deductible health plans are great if you don’t get sick,” he said.
- Thomas pointed out that often people do not understand the health insurance plans they are buying or what they include. They don’t realize the premiums may be small, but what they pay out of pocket could be large. Because of this, providers often are the ones explaining plans to patients rather than insurance companies, he said.
David Fisher, vice president for health care policy and strategy at Siemens Healthcare, spoke after the round table about “Diagnosis in a Value-Based World,” sharing how misdiagnosis of conditions resulted in waste in the health care system. “We don’t fully understand how often misdiagnosis occurs,” Fisher said. “We have to measure it.”
Closing the conference was Dr. Kaveh Safavi, global managing director for health industry at Accenture. He spoke on “Getting Your Money’s Worth Out of Health Care with Digital Technologies.” He pointed out a difference in the way people think about health care costs: “It’s not that the public thinks we spend too much on health care, it’s that they think we don’t get our money’s worth.”