It’s no secret that today healthcare is expensive and the traditional model for delivering healthcare services is not sustainable. Issues of cost, access, quality, and satisfaction are a drumbeat across the U.S., particularly as healthcare costs continue to consume an increasing percentage of the GDP. In 2016, healthcare costs consumed 17.9% of GDP, which was calculated as $10,348 per person/year. In 2018, estimates show growth to 18.2%. In other words, 18 cents of every dollar are spent on healthcare.
The traditional model of care delivery has evolved more to a transaction of care – or what is known as fee for service. For each service there is a fee charged. Doctors and healthcare systems are paid for performing tests and procedures and providing services in various healthcare settings (clinic, hospital, ER, etc.). There remain valid needs for fee-for-service care, although at Winona Health we are more interested in the deeper relationships that have been our history and practice in serving the Winona community. It is what we value.
The advent of chronic conditions, as well as significant advancements in medicine and technology, has opened the door for new care delivery models and more cost-effective approaches. At Winona Health, we have been refining the traditional model as well as developing new models in partnership with key payors (e.g. Medicare and Medicaid). Our focus, regardless of model, is to continually assess and address patient concerns of cost, access, quality and satisfaction. We are excited about the advances we have made on these factors in our value-based or population health work.
Preventable chronic disease is a major driver of rising healthcare costs. To get healthcare itself on a healthier path, Medicare, Medicaid, and health plans are increasingly using “value-based” payment models that reward healthcare providers for improving population health through prevention and early management of emerging chronic disease.
Winona Health has been at the forefront of piloting new models of care to help individuals stay healthy or better manage an existing condition while also finding less expensive ways to provide that care. This involves being proactive in preventive-care screening and education and using a team approach that includes nurses, social workers, therapists, technicians, pharmacists, and more – right person, right work, right setting.
Integral to these efforts, we also address nonclinical factors that affect an individual’s health that take place outside our walls. Things like lack of safe or stable housing, deep poverty, language and cultural barriers, lack of transportation, poor health literacy, and lack of access to nutritious food. These factors are referred to as Social Determinants of Health (SDOH).
To address these non-clinical issues, we work collaboratively with other community organizations that provide complementary services and resources to ensure we’re not working in silos. Our community-based model focuses on efficiently and effectively coordinating multiple efforts to best serve community members. Winona Health continues to provide a complete complement of primary care services across the spectrum from birth to end of life. This is our mission and our passion.
As Winona Health approaches its 125th anniversary forging ahead into the future of healthcare, we’re energetic and optimistic about finding new ways to provide care for our community—to help individuals not only live longer, but to celebrate healthy, happy, high-quality lives.
Rachelle Schultz, EdD
Through this digital column, I hope to shine a light on what we’re working on both internally and beyond our walls in collaboration with other community-focused organizations.