About a month ago I began provider site visits across Massachusetts as a way to better understand health care system delivery issues, local market dynamics, challenges, and opportunities to integrated care and provider leadership visioning in an evolving health care marketplace.
Last week I spent some time with several providers in Western Mass. and got an up-close view of their innovative responses to reimbursement challenges, evolving patient utilization trends, and integrated care planning. A few key lessons merit pointing out:
- First, these providers recognize that they are employers –- often the largest employers in the area –- and that they are uniquely positioned to “nudge” consumers’ health care decisions toward complete, integrated, and lower cost care. By partnering with other area employers, these hospitals and physician groups are beginning to develop "purchasing networks" that collaborate with insurers to create low-cost, local-care plans for their employees. Their goal is twofold: lower the annual cost of care and premiums and develop innovative health care benefit plans that better meet the specific needs of their employees.
- Second, Massachusetts is a dynamic state and every area is very different. Western Mass. is confronting its own set of challenges and operates in a distinct labor market from the eastern part of the state. Small businesses make up the majority of their business leadership and employment base and as such there are fewer dedicated human resource managers to handle their health benefits. Providers operate in challenging market areas (including competition from Connecticut and New York) and must plan for geographic realities that are different from eastern Mass. In particular, recruiting a highly-skilled workforce to isolated community hospitals can be difficult.
- Third, these providers are not working in isolation: hospitals, physician groups, employers, and health plans are at the table, collectively redesigning a health care system that is rapidly evolving. From access to primary care and "wrap-around" care, to smarter insurance benefits that reward quality and prevention, every stakeholder is thoughtfully engaged and planning for a health care delivery system that is moving toward better coordination of care and where more must be done with less dollars.
Because there is no one “right” solution for mitigating health care costs and system redesign in Massachusetts, we must be thoughtful, cautious, and pragmatic as we redesign our strong, yet complex, health care delivery system. Western Mass. offers some simple yet smart principles for us to consider as we continue to better plan for system integration: employers (of all sizes) must play a critical and active role, solutions must be tailored to the market realities of the geographic area, and candid and ongoing cooperation from all stakeholders is essential.
Super Bowl Picnic! posted on Jan 26
Our much-beloved New England Patriots are contending for the Super Bowl this Sunday! And the big questions are…who will you watch the game with? What will the best commercial be? And, let’s face it—what goodies are we going to eat? Back in the days before …Continue Reading Super Bowl Picnic!
Weekly Flu Report, January 23, 2015 posted on Jan 23
The latest weekly flu report shows an increase in rates of flu-like illness during the past seven days. Flu season is certainly here in New England – but there are some simple, common-sense steps that you can take to keep from getting or spreading the …Continue Reading Weekly Flu Report, January 23, 2015
Weekly Flu Report, January 16, 2015 posted on Jan 16
The latest weekly flu report shows a slight decline in rates of flu-like illness over the past seven days. But flu is unpredictable, and we know from past years that flu season won’t likely peak in Massachusetts until February or March – so there’s still …Continue Reading Weekly Flu Report, January 16, 2015