Tuesday morning started with a presentation from Tennessee Governor Philip Bredesen (D) who recently released Fresh Medicine, a book with his ideas on how to reform the American health care system. After his presentation, Bredesen was joined by a panel of children's hospital CEOs who offered their own ideas and participated on an open dialogue on broad strategies for health care reform.
Steven Altschuler, MD, president and chief executive officer, The Children's Hospital of Philadelphia, gave his vision for a health care future that focuses on a robust primary care network with a medical home for every child, utilization of outpatient care as often as it is appropriate, and a transition where the children's hospitals of today become the pediatric regional intensive care units of the future.
Steve Allen, MD, chief executive officer, Nationwide Children's Hospital, shared about the Partners for Kids programs at Nationwide, a physician hospital organization that has helped expand access for children across the state, radically improve pediatric vaccination rates, decrease preterm births, decrease hospital length of stay and improved tracking of patient medical histories.
Craig Cordola, MBA, MHA, FACHE, chief executive officer, Children's Memorial Hermann Hospital, shared his perspective as a former children's hospital CEO and as the current CEO of a health care system on how the health care system he leads is preparing for health care reform, looking also at some of the state-specific challenges in Texas. The system is working through an extensive analysis of all parts of the organization -- all departments, all hospitals, all processes -- to find ways to streamline and improve care across the organization.
Bredesen offered his own ideas on the present health care reform legislation. He expects that the current laws will cause a dramatic decline in employer sponsored insurance. The financial case for a business to turn over the responsibility to the government is too good for many places to pass up.
The two big issues that must be solved in health care are: how to pay for it and how to structure it. In brief, Bredesen wants to model health care payments after the Social Security program, accessible to every American and maintaining a personal dignity not seen under the Medicaid/Medicare system. For structures, Bredesen promoted a "systems of care" model that pays more attention to coordination of care in an integrated faction.
Bredesen says we must quantify what health care needs to be and agree how to measure it. Checks need to be put into place at every step along the way from the outset. His solution is to publish an annual "red book," a single place where a best practice approach to each disease or procedure is codified for universal use, and implement a way of measuing the outcomes and compliance with the standard.
The biggest challenge he sees is that "health care has become such a narrow party line vote that a lot of dynamics have nothing to do with the policy and everything to do with party line."
DISCUSS:
- What is your hospital doing to prepare for health care reform implementation?
- How would you change health care if you could?
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