Much has been made about the Republicans gaining control of the House in the midterm elections. Potential explanations of why the change in power occurred abound. Conservatives have championed the election as a mandate to reduce health care spending or even scrap the recently passed health care legislation and start over from scratch. On the flip side, others have implied that changing public opinion may be more a function of Americans simply wanting something until they get it. Regardless of political ideology, everyone more or less agrees we’re spending too much money for not enough results.
The focus of controversy in both recent debates and legislation has been largely about insurance reform. What has been absent from these discussions is how health care reform can 1) change how we approach the delivery of health care and 2) support improved health over the life of an individual. Currently, care is sporadic, reactive, uncoordinated, and based on a reimbursement which rewards treatment of disease rather than prevention of disease. If you have any doubt of this just look at any of the highest paid medical specialties – cardiology, radiology, oncology, gastroenterology, and surgery – all procedure based specialties that are well-reimbursed under our current system. We at the Center believe that we can do better than this reactive, procedure-based approach to medicine. Through the use of personalized health plans, providers can quantify patients’ health and health risks, identify strategies to mitigate risks and/or treat disease, deliver personalized care, engage patients in their care, and measure outcomes over time. This set of tools can then be used to more effectively implement coordinated care and more accurately measure performance for reimbursement. While PPACA and its attempts to address inadequacies in health insurance and coverage may be stalled by political turmoil for some time, the health care community can use personalized health planning to start to work towards meaningful health delivery reform now. And as we argue in a recent commentary in Academic Medicine, PPACA’s focus on the development of coordinated models of care, provider reimbursement reform, and personalized health planning is a significant opportunity for academic medical centers to lead the way in health care reform.