How integration will revolutionize our healthcare system
“One hand doesn’t know what the other is doing.” It’s a cliché, but it’s a vivid metaphor for the chaos that occurs when a body isn’t working together. It also serves as an apt description for the majority of today’s healthcare delivery.
The men and women working on the front lines of healthcare, and those working behind the scenes to fundamentally change the way care is delivered will tell you the biggest road blocks between our country and better health are inefficiency and waste. They’re also the factors driving the consistent rise in healthcare spending.
The treatment of and preventive care for costly chronic diseases are better and more dependable than ever before. When it comes to the delivery of healthcare, we are many hands working to achieve the goal of more effective, realistically-priced care. We can achieve this by bringing together providers, insurers and patients in a new approach to care.
This approach, known as integrated healthcare, is growing in popularity and demand in our country. At its basis, IHC is a shift in the way care deliverers and health insurers work together, with health insurers working to connect medical, pharmacy, dental, vision, life and disability benefits and data across providers. It’s a way to connect providers to the information they need to deliver more efficient, holistic care, and encourage the collaboration that drives cross-specialty insight.
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IHC is the most powerful driver in creating stronger care management programs. For members/patients at high risk for developing costly illnesses, IHC represents a more connected, less frustrating healthcare experience. Chronic diseases, which are responsible for 7 out of 10 deaths in America, also drive 86% of our healthcare costs. We believe many of these preventable illnesses — and unnecessary costs — can be avoided through a holistic approach to care, delivered via more informed, involved care management programs. Care managers, armed with patient background information, have the capacity to stay connected to patients and ensure they’re receiving the right care at the right time. They’re able to tailor care plans to patient goals, and advise patients on how to maximize their benefits.
An important part of achieving these impacts is to change benefits design to promote integration that works horizontally (across professions/specialties) as well as vertically (through levels of care). It begins with a strategic plan for population-level health management across all participating providers and systems. Large health insurers are uniquely positioned to promote IHC throughout their networks by making it a prerequisite for taking advantage of the tools and programs enabling better care delivery. Although implementation is complex, it is not unachievable.
Opening the Lines of communication
The second piece of the puzzle is communication— sharing of data between care providers. Maintaining HIPAA compliance and patient privacy is goal number one, and advancements in data sharing have made it possible for providers to safely work together digitally, contributing to more complete health records and benefiting from one another’s insights. Provider access to information such as previous diagnoses, prescription history and test results can and do prevent medication mistakes, duplication of testing, and enable earlier detection of gaps in care.
Although this is a high-level view of IHC, there are several examples showing how this approach works in the real world. A recent study conducted by Employee Benefit News (LINK?) found that among employers implementing IHC programs, more than half are already seeing savings, with nearly a third able to point to specific health improvements like weight loss and smoking cessation. Among employers already offering integrated healthcare, 82% have found it highly valuable to have a coordinated care approach and clinical integration across all benefits, according to the “5th Consecutive Employer Survey of Integrated Disability, Absence, and Health Management Trends 2014” that was conducted by Spring Consulting Group, LLC.
Integrated healthcare is bringing a big-picture view of health to the forefront of our national healthcare conversation. It’s the right approach to fundamentally changing the way healthcare works, and making it work better for everyone. IHC is the way forward—the way we’ll ensure all the hands that make up our country’s healthcare workforce are working together to build better health, more efficient care and stronger savings.