Community Hero Playbook: Health Care and Hotspotting
WHERE WE ARE
According to data from the CIA, America ranks 50th in life expectancy, behind countries such as Greece, Portugal and Bosnia and Herzegovina. Our health care outcomes are comparable to countries such as Chile. Any country that cannot take care of its people when they get sick will collapse – and that’s the risk of non-engagement on this issue.
WHERE Community Hero’s Are Leading Us?
Health networks are increasing health outcomes while reducing health care costs simply by identifying and healing the sickest patients first.
Often, the reason the care is so costly is because it isn’t treating the person correctly. For instance, a frequent emergency room visitor might not be able to take his insulin shots, because of poor eyesight. If you get that person glasses, he won’t have to go to the hospital. Yet we spend more than twice as much as any other country on health care system. Why is this? It’s because American health care has almost nothing to do with health outcomes, and everything to do with incentives to use as many resources as possible. Our doctors and hospitals are paid based on how many services they offer, not based on health outcomes. Our pharmaceutical companies make money selling more medicine for more money than curing anything. Our insurance companies have created an enormous bureaucracy where waste and paperwork take the place of smart decisions. It’s a mess.
Beyond that, patients with complex problems have two options – a doctor or a hospital, and nothing in between. This means that we deliver care to people in precisely the wrong way.
So how are people handling this situation better in their communities? One method called hot-spotting was pioneered by Dr. Jeffrey Brenner in one of the poorest communities in the country: Camden, New Jersey. Dr. Brenner noted that a very small percentage of patients caused most of the health care costs, and that additional spending on them didn’t improve health outcomes. It was how they were treated that mattered.
In health care delivery, hot-spotting means targeting key resources to those patients who are the costliest to the system, and spending time and effort to treat them specifically. This is what Brenner did. He didn’t just give insulin to the diabetic who was constantly being rushed to the hospital, he sent a team member to ensure that the patient’s eyesight was good enough to administer his own medicine. The patient got new glasses, and costs came down.
This core insight provides that template for most successful health care practices, from the Mayo Clinic to Brenner’s work in New Jersey to the Special Care Center in Atlantic City.
Community Hero PLAYS you can practice now