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Health care costs tackled, changing

Posted: Tuesday, Jan 29th, 2013

Project coordinator,

Get Healthy SLV

VALLEY —In 2012, Robert Wood Johnson Foundation (RWJF) a grant making foundation focusing on improving health, conducted focus groups in four American cities to gauge consumer attitudes on health care costs. The focus groups revealed that although most Americans are unclear as to why health care costs are increasing, many if not most know down to the penny how those increases are affecting their wallets.

This should be expected in a time when workers covered through their employers pay 97 percent more for their family insurance premiums than they did in 2002, while wages increased just 33 percent over the same period. This reality is forcing individuals and families across the nation to cut back on spending in all areas of life including starting a family, buying a house, and buying a car.

Beyond the monthly mortgage and car payments, more families are also going without medical insurance. According to the Colorado Health Access Survey conducted by The Colorado Trust, an additional 2,800 individuals in the San Luis Valley have become uninsured since 2008. This is the second highest rate of uninsured in the state, with nearly one in four Valley residents being uninsured.

Without insurance, more Valley residents are postponing or foregoing needed medical care. By waiting longer to get the care they need, many suffer from worse health outcomes and, ironically, even more costly medical expenses.

To address rising health care costs and the continual need for increased access to quality and affordable health care services, The Commonwealth Fund, a national private foundation, released a report this month outlining a series of payment reforms designed to slow health care spending by a cumulative $2 trillion by 2023.

In 2012, health spending constituted 18 percent of the US gross domestic product, up from 14 percent in 2000. Current projections put health spending at 21 percent of GDP by 2023. Per capita, this means Americans spend 50 percent more, as a share of GDP, than other industrialized nations on health care. Yet, Americans have shorter life expectancies, lower infant mortality rates, and decreased quality of care.

The Commonwealth Fund proposes 10 policies to stabilize spending growth. Ranging from payment reforms, like rewarding physicians for improved care management and health outcomes per patients, to enhanced patient information to better inform treatment decisions, the policies are designed to create a health care system that is held accountable for the cost of care, patient health outcomes, and the patient’s care experience.

The theory behind these proposals is being tested locally. The San Luis Valley Regional Medical Center is participating in The Comprehensive Primary Care Initiative, CPCI, a national pilot occurring in five states and funded by the Center for Medicare and Medicaid Services. The initiative will bolster services for patients with high health care needs while modifying financial reimbursements for some providers. Through increased coordination of care, the initiative should result in improved health outcomes with reduced complications for individuals struggling with one or more chronic diseases.

In order to better engage and improve employee health, SLVRMC is also partnering with Engaged Public, a Denver-based public policy strategy firm, SLVHMO, and the Colorado Health Institute to modify its employee health insurance program to improve care and decrease costs.

This new initiative is called Engaged Benefit Design. The initiative is based on two principles: patients should have easy access to services and treatments that research proves effective; patients should have easy access to information that informs decisions on conditions and treatments that research differs or treatment options vary.

Such initiatives, including the use of patient decision aides, are gaining attention nationally. All too often, patients only hear about one treatment option. By ensuring that patients are fully informed and treatments are better understand, patients tend to choose less invasive and therefore less expensive treatment options.

Additional health care reform initiatives are explained at GetHealthySLV.org.

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