‘Disruptive innovation’ can help reshape health care

“Knowing is not enough; we must apply.Willing is not enough; we must do.” — Goethe

For decades, Mesa County has benefited from a health system that refused to operate like the rest of the health systems in the United States. As a result, the citizens of Mesa County benefit from a more cohesive and integrated practice of medicine than in most other areas of the country.

Nevertheless, despite these successes, and despite large savings to the Medicare and Medicaid systems, the price of private insurance here on the Western Slope is still rising at an alarming pace.

Like a noose around our necks, the economic costs to our local agencies and businesses are profound.

So, it is time for some “disruptive innovation.” It is time that businesses join together. It is time for innovative change in health care once again in Mesa County. 

Much like the rest of the country, business leaders across Mesa County have deep concerns regarding the ever-rising health care costs. These expenses keep business from hiring and expanding.

Indeed, health care costs have a stranglehold on economic development. Control health care costs and we can stimulate the economy of the Western Slope faster than you can say “natural gas.”

Together, a business coalition on health care can incentivize and encourage higher value health care. And because businesses pay a large portion of health care costs via employer-based insurance plans, they have every right to demand a higher value product. Unfortunately, for several decades, businesses have not known what to ask for with respect to this endeavor. Plus, they have not been organized.

On both accounts, that has changed. And now proven methods for disruptive innovation lie waiting in the wings. A few important examples include:

✔ A movement away from fee for service medicine. Alternative payment models offer mechanisms to reinforce value over volume. Bundled payments and global payments are just two examples.

✔ Value-based health care where less useful medical procedures and treatments have higher copays and high value services have little or no copay.

✔ High-level chronic disease management performed at medical homes with advanced methods for communicating with and caring for patients.

✔ Transparency on cost and quality.

✔ Greater responsibility from the workforce via healthy choices and healthy behavior. This can be done through wellness programs at a business and can be done at the community level by disincentivizing unhealthy behavior. Yes, business leaders should embrace new tax incentives for healthy behavior and new taxes on unhealthy behavior. Without a doubt, your business is paying a huge price for tobacco, alcohol and obesity. 

With respect to cost savings, don’t look to Obamacare, Paul Ryan or the politicians in Denver. With the right partnerships, Mesa County business can accomplish this task right here at home.

We must do the heavy lifting.

What we need is the collective voices of business leaders from across Mesa County. The new health care business model must work for the whole community rather than just the health care community. Via a healthy dose of accountability, the new health care business model will incentivize value over volume. And, it will encourage responsible lifestyle choices among the populace. Together, we can receive greater value in health care.

This process will require changes to how we pay providers and hospitals. It will require more personal responsibility. The alternative is less attractive: Mesa County leadership could stand around and wait for politicians in Denver and Washington D.C. to attempt this cost reduction task in their vision.

Certainly, a willingness to engage in disruptive innovation will provide the needed economic stimulus right here in western Colorado. It’s the same disruptive innovation that put Mesa County’s health system on the map in the first place.

This time, business leaders outside of the health care industry must help lead the way. 

If you are a business leader in Mesa County, it’s time to act. A local committee in Grand Junction is exploring options in this arena. You should contact Diane Schwenke at the Grand Junction Chamber of Commerce and add your business to a growing force for change.

Michael J. Pramenko M.D. is the executive director of Primary Care Partners. He serves on the Club 20 Health Care Reform Committee and is a past president of the Colorado Medical Society.


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