Straight Talk - "American Hospital Association (AHA) Update"

June 21, 2012

Dear Friends and Colleagues,

You can learn a lot from the American Hospital Association (AHA), which gathers input from almost 5,000 hospitals of all sizes and types from around the nation. Last week our southeastern Regional Policy Board met in Alabama, and here is what we learned.

  • Redesigning Primary Care. A report from the Robert Wood Johnson Foundation disputed the notion that America faces an imminent shortage of primary care providers, concluding, “Numbers of physicians, nurse practitioners and physician assistants have grown in recent years relative to the general population.” What is bothersome is the profound maldistribution of caregivers, resulting in severe shortages in rural areas and among overlooked populations. A new care model is needed; a team approach including a physician leader, one or more nurse practitioners or physician assistants, social service, dieticians and others can better care for the 5% sickest patients who use 50% of healthcare resources. As to the rest of us—we, too, can be cared for in innovative ways. One such is using “Dr. Watson.” This IBM-created computer understands most languages, can obtain a medical history over the internet, gather lab and radiology information, make a diagnosis and send a prescription to a nearby pharmacy on your insurance plan. The Dr. Watson system, already functioning in several states, also completes the paperwork aspect by debiting a bank account and securing insurance company reimbursement. Other innovations in primary care include Wal-Mart planning primary care clinics in its almost 4,000 stores, within 15 miles of 90% of Americans. Primary care is so important for the economic health of our nation; if we can prevent illness, we will have stronger individuals, more satisfied communities and a more self-sufficient nation.

  • Sustaining Medicare and Medicaid. Regardless of the Supreme Court decision on healthcare, we must make our system more efficient by embracing such things as adopting evidence-based medicine, reducing unnecessary testing and treatment, applying appropriate end of life care, investing in robust information technology as a backbone, and rewarding performance based on value (quality or outcome divided by cost). Promoting personal engagement by patients is the other half of the equation. Everyone agrees we need to focus on caring for ourselves (by utilizing such tools as smoking cessation and weight control). But there is debate as to whether Medicare and Medicaid should evolve from a traditional fee-for-service to fully managed care, or even evolve to a system giving patients funding to shop and buy their own healthcare insurance.

  • Update from Washington. The report from the nation’s capital was concerning, mostly revolving around the government not having enough funds to sustain the level of healthcare reimbursement we have all come to expect. The average American family’s net worth has dropped by some $50,000 during the most recent recession. When coupled with the projected need to have $20,000 per person per year in retirement just to pay for healthcare, this is a serious concern. Such uncertainty relative to limited healthcare resources makes the AHA rallying cry that much more critical: We Care, We Vote.

Finally, one note of “certainty” to conclude: I’m delighted that Director Beth Jameson and Operating Manager Lois Schaeffer have announced that the Briggs and Whitaker Wellness Centers have been awarded the SW Florida Choice Award for 2012 for the 10th year in a row. Great job everyone, and keep up the wonderful work that you do.


Allen S. Weiss, M.D., President and CEO

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