Review - Health and Human Services Strategic Plan for Fiscal Years 2010-2015

...

a newfound commitment from hospitals to the community as they try and ascertain what their needs are. One area we need to improve on is substance and drug abuse. This is a very area to make a solid impact and as a nation we are in a war on drugs. The heroin and opiate abuse has never been worse and if not for reversal agents the number of deaths would be alarmingly higher. This is a tough area to break into as a lot of these people are past the point of no return, but we must develop a way to intercede in this downhill battle.

The fourth goal is to reduce the growth of healthcare costs while promoting high value effective care. This is really being pushed by hospitals to develop a value based model and focus on the best care with the least financial impact on both the insurance companies and the patients. This is where the sharing of evidence based medicine is pivotal in the success of providing a high level of value. I am truly concerned with the success of this initiative as healthcare costs; especially those who are utilizing Obamacare are raising rates in a quick and alarming fashion. The plans that are left that still participate in Obamacare are raising their rates every year and are impacting the consumer a great deal. I often wonder how these insurance companies can make money hand over fist and then when they are asked to make cuts, they leave the ACA. The government needs to intervene as this is happening quickly. N.J. had five companies in the ACA last year and only have two left. This allows for an increase in pricing as the market has shrunk and there is less competition. We are up against it in this area and I see no quick remedy available.

The fifth goal is to ensure that vulnerable populations have access to quality and culturally competent care. We are doing well here, but we must continue to monitor access to these populations at the Federal, State, local and tribal levels. This takes a great deal of communication and a commitment from the citizens of these groups and their providers. I think the level of care is just as good as they would get anywhere else in the nation and the focus to remain at a high quality level is intact. We must continue to educate the benefits of the ACA and the importance of having health benefits. We often see lower income populations losing their insurance as they cannot pay the deductibles associated with the plan. They can pay for the plan, but as soon as they are hospitalized and are forced to pay a deductible, there is a decision that the patient makes and it is often to not pay for the insurance. One very large area is the care provided for mental health patients. We are not meeting this whatsoever and there are placement issues across the nation as to find someone and somewhere to care for these patients. We have to find a way to develop mental health centers and long term care facilities for this patient population. This is often a failure because the insurance plan does not want to pay for mental health issues and the patient is left in limbo

The last goal is to promote the adoption and meaningful use of health information technology. We have done very well in this area as the goals of meaningful use are achievable, at least for now. The incentives the government has provided in adopting and utilizing the electronic health record has made us more efficient in providing healthcare. We must continue to raise the levels of achieving meaningful use and adopt new areas in where meaningful use can help. It seems that all of the areas promote patient safety whether it is bar-code scanning or the HER. It puts information that used to be located in five different areas of a paper chart all in one area. This allows for multiple specialty providers and ancillary staff to all see the same medical record in the same fashion. The next steps for success in this area needs to be the adoption of a nationwide HER that allows any provider anywhere to see anything and everything that has been done to the patient over the last decade. It limits uncertainty and allows the providers to ascertain a better historical concept on treating the patient.

Overall, I think the Strategic Plan developed has had its successes and failures. I think that the provision of better patient care has been met, but the financial impact on the patient has not fared as well as predicted. We must continue to provide value based care and utilize best practice so that we can meet the needs of the community in a similar fashion. Once this is somewhat standardized, we need to reward HCO’s that are performing well instead of punishing those monetarily that are not meeting the standard. This only limits the amount of technology and value based purchasing that can be done and limits the ability to provide the best possible care to the

...