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Health Engagement and MLK

By Cyndy Nayer, January 21, 2014

It’s Martin Luther King Day 2014. The sun is shining and the quotes are flowing on the media.  Each year I seek one of his quotes to guide my efforts:

Human progress is neither automatic nor inevitable... Every step toward the goal of justice requires sacrifice, suffering, and struggle; the tireless exertions and passionate concern of dedicated individuals.[1]

I continue to seek the comfort of his timeless words because rest does not come easy to an innovator, a “change agent,” just as it does not come easy to a country in need of predictability and trust. The trial-and-error distress of health care transformation feels like a weight on the US business and health care delivery systems.  In an era of uncertainty, the goal of health improvement has been a sidebar.  The Affordable Care Act suffers from a tiresome rollout on a dysfunctional website, but the real malaise is the weariness of those who see promise in the accessibility of care by all. At these moments, Dr. King’s words inspire the courage to persevere.

In order to create predicable, sustainable business growth in the health care sector AND the general business community, we must aim for engagement of all the health care users and providers in order to achieve better health.  Better health care is a tool, just as better jobs, better education, and better roads are tools towards economic security.  These goals are not held solely in the health care delivery sector nor the US or state governments.  The power of better health lives in all of us.

We need health engagement across all of the stakeholders. Consumer-driven must not be “consumer choice” without consumer input.  Patient-centered cannot be decided around the patient without the patient and/or patient-family input.  Provider reimbursement must not fall only on the physicians and hospital networks, but to all of us to create the economic justice that will support the long-term change.

From packaging data and purchasing services, from bundling payments to building centers of excellence to increasing jobs, each strategy must address the question, “will this build better health?”  If we are to build this vision of health, which, by definition demands the alignment of goals for all of those that touch “health care,” then we must define the alignment needed and disconnects that exist.  Some of the most obvious are:

  1. In an era of high-deductible health plans, asking the patient/consumer to adhere to a treatment regimen that is unaffordable;
  2. Ignoring depression or anxiety in the treatment of a chronic condition, which can derail the success of a patient to get to optimal health;
  3. Changes in evidence and safety recommendations that take years to get to the primary care physician and his/her staff;
  4. Misaligned payments, such as fee-for-service in primary care when the goals are adherence to lifestyle and treatment regimens—this misalignment drives up total costs without regard to patient or provider commitment;
  5. Purchasing health services, devices, communication, and treatments without holding the vendors accountable for outcomes, and most especially accountable for improved engagement and adherence in high-cost condition management.

These obvious disconnects are the rationale for recasting the Health Value Continuum as an engagement framework with defined goals, from waste reduction (paying for readmissions, paying for emergency care with no emergency, and paying for risk appraisals with low participation) to organizational performance, and ultimately to community sustainability (wherein there is measurable improvement in health and economic risk). 

In short, getting to health, wealth and performance demands engagement and accountability for our own health and wealth.  Our personal commitments must be mirrored in the organizational accountability from the providers, systems and payers.  These personal and system commitments should reflect in the policy improvements that will support interoperable technology, innovation, and reduction of food deserts, among other lofty goals.  Can we get there?  We can, with the faith that we are on the road to better lives, as Dr. King envisioned.  Our faith and courage will take us to the health quality and efficiencies that every community in the US needs and deserves.


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