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The Patience We Need for Meaningful Health Care Reform

February 01, 2019
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Speed. It’s everything right now. We want our information faster, our transportation quicker, our products to reach us with virtually no wait. A new jet is in the worksthat would sweep passengers to Beijing from New York in three hours.

This need for speed is not new, but as it intensifies, our perception can change for how quickly everything is supposed to happen. I had a high school teacher who talked constantly about delayed gratification, trying to impress upon us that it takes persistence, patience and adaptation to see results. Those results, he implored, do not occur in hours or overnight but after weeks and months and even years of dedication to the vision.

Years later, I get it. Not everything happens as quickly as news notifications and Amazon acquisitions. Some of the best and most important efforts require that we continually move forward knowing that big results will come if we stay on course.

This is precisely the case with the health reform work we are doing now in Vermont.  We are wisely moving to a population health model where the goal is to work proactively to keep people healthy instead of waiting for them to get sick to provide care. It is about prioritizing prevention and wellness the way we do treatment and disease management.

If we want to change the trend of health care cost growth and provide more patient-centered care, we can’t keep doing the same things the same old way. Here in Vermont, we’re not. We are transforming our health care system to deliver the best outcomes for patients instead of the most procedures, office visits and hospital stays.

Access to healthy food, recreation paths and community resources can be as important as access to doctors and hospitals. The availability of transportation in rural communities can help patients manage instead of neglect chronic conditions. Telehealth can help bridge the difference between waiting months to see a specialist and accessing one within days or hours.

All of this work is happening under the All-Payer model. It is not easy or fast – changing how health care is paid for and delivered takes time and careful coordination. In our state, hospitals and their provider partners are doing that work together. The model is already producing results and will continue to do so if we stay focused on the shared goal of holistic care at a lower cost.

Our cultural expectation of speed will only grow as technology—and communication—advances at a breakneck pace. We must be cautious of allowing that need for speed to cause us to veer off course and seek out the next best thing.

Focusing on value instead of volume makes sense. Expanding primary care is the best way to orient the system around wellness, prevention and health maintenance. Preventing and monitoring chronic conditions is the only way to both make patients healthier and save system cost. This is about providers changing how they deliver care and patients changing how they care for themselves. None of this can happen as fast as we want. It definitely will not happen if we give up before the investments being made have a chance to pay off for patients and the system.

I am more confident each day this work is the right thing—and we are going about it in a responsible, thoughtful way. Expecting great results is vital to our success. Expecting them too soon is a recipe for disappointment.

Jeff Tieman, VAHHS CEO