Changing the Model

The healthcare landscape is undergoing tremendous changes. We don’t know the outcome of the elections this fall, but we do know that healthcare reform will continue to be a critical issue because the system as it has existed for decades is not sustainable for the long term.

No matter what happens in the nation’s capital, the most effective reforms will happen through cooperation at the local level, not because of directives from Washington, D.C., or Austin. Effective change will happen only through close collaboration among physicians, health systems, employers, community leaders, and payers.

Here are some eye-opening statistics. Companies in the Dallas-Fort Worth area suffer an estimated $17 billion loss in productivity each year due to employee health problems. Personal health behaviors influence 50 percent to 70 percent of an individual’s health, yet we spend only 4 percent of our health dollars to impact behaviors.

One of the keys to meeting the challenges ahead is to expand the focus from caring for people when they are ill to proactively keeping people healthy.

Sometimes people have little control over their health due to accidents, genetic-based diseases, or other risks for certain diseases. Our health system will always stand ready to care for them with dedication and compassion. But our mission is to improve the health of the people in the communities we serve, and that means we must help people live healthier lives and, hopefully, stay out of the hospital.

We must inspire change in the way people think about their own health and how they act. By implementing behavior interventions, we can improve health and outcomes over the long term and ultimately improve overall well-being. That is the only way we can improve the health of the people in our communities and bend the cost curve of health care away from its upward trajectory.

To do that, Texas Health is transforming from a hospital system to a health system. Texas Health will continue to focus on patients’ needs, and the hospital will continue to be the most prominent and visible manifestation of the work we do every day.  But other pieces of the continuum of care will grow in importance, including primary care, wellness and prevention, and post-acute care services.

Transformation through Collaboration

Collaboration is the key to the future. To shift from focusing on sick care to keeping people healthy, Texas Health and other healthcare providers are collaborating across the continuum of care.

We use an analogy of the acute-care hospital as a box on the table with a lot of other boxes around it. There are other parts of the continuum of care to the left and to the right, from primary care, wellness, and prevention to post-acute care including rehabilitation, home health care, palliative care, and hospice services to medical research and education.

During the coming months and years, you will see Texas Health bring all of these pieces together in a coordinated whole through partnerships, affiliations, acquisitions and growth from the ground up.

Earlier this year, for example, Texas Health, Methodist Health System, and LHC Group announced a collaborative effort to deliver home health care for regional patients. Texas Health and North Texas Specialty Physicians are collaborating on the Plus ACO, an accountable care organization that is one of 32 organizations in the federal Pioneer ACO Model. There are many other collaborative efforts on accountable care in the works.

Improving Well-Being

Texas Health is also collaborating with Healthways Inc. to develop what is needed to connect people to their own health, connect people with their doctors, and connect people within their communities. Working together with physicians across North Texas, we are focusing on the science of behavior change to improve health and overall well-being.

We believe people with higher well-being are healthier, happier, contribute more to their communities and jobs, and have lower healthcare costs.

The Gallup-Healthways Well-Being Index is one of the measures being used by forward-thinking employers and communities to evaluate their environment as a first step in making improvements that foster better health and well-being.

Well-being is more than just physical health. The Index considers six areas of well-being that include people’s perceptions of their:

  • Life evaluation
  • Emotional health
  • Physical health
  • Healthy behaviors
  • Work environment
  • Basic access to food, shelter, healthcare and a safe, satisfying place to live.

Research in other parts of the country has shown that for every one percent rise in the Well-Being Index, health care costs drop 2 percent and hospitalizations go down 1 percent.

Physician-Directed Population Health

The next era of innovation will be led by doctors and other clinicians. Texas Health is going to enable that innovation.

As a health system, the most immediate impact we can have is to help physicians improve the physical health and overall well-being of their patients. So we are shifting the model of care toward one of physician-directed population health.

The ultimate goal of this new model is to provide physicians the tools, data and support to enhance well-being, lower costs, and help them better manage their patients’ health. These are things physicians have needed and wanted.

We are developing infrastructure, protocols, and robust health information technology systems in partnership with physicians, using Texas Health Physicians Group as a proving ground. We will then share with independent physicians the knowledge and tools we develop.

We will meet the challenges of transforming health care and creating a sustainable model for the future. That will require collaboration and coordination among physicians, health systems, employers, and payers. Success will also require the engagement of the people in our communities who must take an active role in improving their well-being. We encourage others to collaborate with us in improving health and well-being.

Douglas D. Hawthorne is CEO of Texas Health Resources.

  • Marydele Porter

    I think that my doctor who I have gone to for nearly 40 years has been the kind of doctor who believes in preventative medicine. Fortunantely I have been in good health. The doctor / patient relationship is so important . So many people do not have good access to good doctors. My small community of Mathis really does not have a full time doctor making it necessary to travel to Corpus , Beeville or Alice and SanAntonio. Small communities have a problem.