Health care changes are driven by more than reform law; Beshear says patients need rewards for changing their behavior

“Your doctor’s visits might get longer, you deductibles probably will be
higher and you might be paying cash to be treated at a Wal-Mart near you
as Kentucky adapts to a vastly changing health care landscape,” Mary Meehan reports for the Lexington Herald-Leader. “Nearly everything you know about how health care is paid for and
provided will change during the next few years as patients and providers
sort out the nuts and bolts of the Affordable Care Act.”

But it’s not just the health-reform law that’s changing health care, Meehan reports from the Health Leadership Summit, held Thursday in Frankfort by state government and the Kentucky Hospital Association. She paraphrases the main speaker, Chas Roades, chief research officer for The Advisory Board Co., a Washington-based health consultant firm:

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“Even if parts of the law are dismantled, he said, the health care
needs of aging baby boomers are driving a fundamental change in the
system. If patients have more choice, he said, it will be important for
doctors to make more personal connections with patients. The focus won’t
be rolling patients through the door at a furious clip but on spending
time with them to find out what it is going on.”

Roades said the focus is shifting from treatment of illnesses to prevention, so health-care providers will be rewarded for keeping people healthy, and the transition period for health-care providers will be tough. “We need to get from fee-for-service to fee-for-value,” he said, but until all government programs pay on that basis, and 75 percent of private insurance does, “We won’t break even . . . We have to get everybody moving in the same direction at the same time.” But he said the transition will be tough for hospitals that are small, rural and not connected with a larger organization.

State Health Secretary Audrey Haynes, who convened the meeting, said “We have to figure out how to have quality health-care services in the rural area of the state just like we do in the urban area.”

One attendee at the meeting asked Roades when providers and payers could expect to see patients changing their behavior and being more responsible about their health. “We have to walk a fine line,” he replied, suggesting that the focus needs to be on “rising risk” patients, 15 to 35 percent of the population, who may not have their chronic conditions under control.

Roades said educating people about better health should involve community organizations such as churches. “The average American has a fifth-grade health literacy,” he said.

Gov. Steve Beshear said one key will be finding ways to reward patients for making responsible, informed choices: “We will fall short of our goals if we can’t find ways to engage our patients in new and effective ways.”

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