Healthy Populations: Rethinking Primary and Chronic Care

At Session 101 of the U.S. News & World Report Hospital of Tomorrow forum, experts discuss how primary care needs to evolve.

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Changes in reimbursement models have propagated hospitals to approach patient care in a different way – one that seeks out ways within communities to keep patients healthy and out of the hospital. This topic was discussed in one of the break-out sessions during the first round of sessions at U.S. News & World Report's inaugural Hospital of Tomorrow forum, in which experts offered strategies that had worked for their hospitals and physicians, from acquiring more hospitals to monitoring patients' weight remotely.

[More Hospital of Tomorrow Forum coverage: usnews.com/hospitaloftomorrow]

Speakers included Michael Englehart, president at Advocate Physician Partners; Gregory Poulsen, senior vice president and chief strategy officer at Intermountain Healthcare; and Andrew Racine, senior vice president and chief medical officer at Montefiore Medical Center. Anne McGrath, managing editor for U.S. News, moderated the session. Here are the highlights:

  • Racine shared that 80 percent of Montefiore's patients are on Medicaid or Medicare, and many are from immigrant communities. In order to broaden the number of people the hospital can reach, it has acquired other hospitals, most recently in Westchester County, N.Y., a location on the border of the Bronx, where Montefiore is, that encompasses patients they see. This increased their numbers from 500,000 patients to 1 million patients.
  • Englehart said that by the end of the year all of the physicians for Advocate Physician Partners will be required to use electronic health records.
  • Advocate Physician Partners has a unique model, bringing together employed physicians with independent physicians to reach different communities, Englehart said.
  • Poulsen said Intermountain Healthcare takes on risk by offering a health plan, which is currently made up of 800,000 people.
  • Intermountain Healthcare has reduced hospital costs through various means, including reducing imaging, reducing the number of days patients spend in the hospital, and increasing prevention care and education, Poulsen said.
  • Thomas McInerny, president of the American Academy of Pediatrics and attendee of the session, said he and his organization were concerned that intervention in health wasn't occurring early enough in life, that doing so would reduce many of the problems that plague people in their later years. Racine replied that it was difficult, especially because children represent 20 percent of the population in the country that are poor, the largest demographic.

All participants said they had made use of technology in order to keep people well, from using a disease registry to communicating with patients through Skype.

Englehart summed up the age of health care affecting so many changes in hospital care: "It's an age of transparency and accountability that is moving toward measurable value."

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