Today’s U.S. health care model is centered on treating illnesses, making the system fragmented, impersonal, expensive and unsustainable. Rather than promoting health and being paid to keep patients well, health care providers are paid to treat a patient’s symptoms or disease.
Rarely are a patient’s total health care needs considered during treatment. As a result, patients tend to be disengaged from their own health and wellness, and their providers are focused on treating a specific health problem rather than identifying ways to prevent a future health crisis.
This approach explains why the U.S. spends more than any other nation on health care – 17 percent of gross domestic product – yet U.S. life expectancy ranks 49 among 224 nations. By the year 2020, it is estimated that health care will cost Americans $4.2 trillion.
Clearly, the U.S. health care system needs to improve.
Novant Health understands these issues and has taken steps to transform health care with personalized care, one-on-one education, 24/7 access to providers and assigned care coordinators. All of these are features of Novant Health’s new approach to care known as population health management.
This approach encourages wellness and preventive care, and manages existing conditions to slow or reverse the progression of disease, all while lowering the overall cost of care.
Key to this model’s success is coordinated care, with physicians, nurses, pharmacists, dietitians, social workers, referral coordinators and others working together as a team to give patients the personalized care they want and need. Ultimately, this type of care provides value – safe, more affordable care with better outcomes – and is centered on the individual patient’s unique needs.
Consider how population health treats patients with chronic obstructive pulmonary disease (COPD) – a common disease that is the third leading cause of death in the United States. Novant Health patients work with a care coordinator to create a personalized action plan with 24/7 support.
The plan is color coded – green, yellow, red – with a list of symptoms and appropriate steps to take. Green corresponds with good days when all is well. Yellow indicates symptoms are worsening, and red means urgent care is needed.
Here’s one example of how it works. A patient was having difficulty breathing and used his inhaler as his “yellow” care plan instructed, but it didn’t help. The next step was to call his doctor and he did. The physician promptly called in a prescription, which brought the gentleman relief.
When the patient checked in with his care coordinator later that day, he shared his story. At one point in the conversation, he paused and said, “I think you just saved me from another hospitalization.” It was an “aha” moment for the patient and proof for the care team that the population health model works. This patient was educated on how to take care of himself so he could better manage his chronic condition at home and avoid an unnecessary hospitalization.
When health care is centered on treating the symptoms, COPD patients were given medication and told to call their doctor as problems arose. Their well-being became a medical emergency when they struggled to get air, and the crisis often resulted in an emergency room visit, which typically led to a hospital readmission.
Now that Novant Health’s focus is on keeping people healthy, some traditional fee-for-service payments will be replaced by newly negotiated agreements focusing on value, where the patient’s quality and outcomes factor into how much providers and facilities are paid.
Novant Health is collaborating with payors and partners to identify payment models that match its value-based care delivery. Novant Health has also been actively supporting its own team members and their families, and will continue to learn from the population health models and how they can serve its broader patient populations.
Getting the right care in the right setting at the right price – that’s the future of health care. It’s what makes care affordable and it’s what makes health care more sustainable. And population health management is Novant Health’s new way of delivering remarkable health care so people can get better and stay healthy.