Opinion and Forefront

DANIELS: Leading in health care innovation

March 30, 2013

DanielsHoosiers are often thought of as resistant to change (daylight-saving time, anyone?).

But in the health care arena, we are leading change. Our Regenstrief Institute is an internationally respected informatics and health care research institute. Indiana is a national leader in electronic-health record-sharing. Our consumer-based health care plan for low-income Hoosiers is a model for the nation.

Those accomplishments alone, however, are not enough to address the anticipated future need for health care services. The passage of the Affordable Care Act (Obamacare) means the downward pressure on providers, in particular those that serve indigents, will continue to increase, while greater coverage will lead to greater demand for health services.

I see the act as a lost opportunity. The way it was forced through Congress without bipartisan agreement, indeed without opportunity for Republican input, caused unnecessary bitterness.

It focuses primarily on access to care, and not enough on incentives to deliver high-quality, low-cost care. It will lead to tremendous expense for taxpayers and reduced reimbursement for providers.

But it is the new reality, and providers must find a way to accomplish their patient-centered mission within its requirements.

Everyone in Indianapolis knows how essential Wishard Health Services—soon to be known as Eskenazi Health—is to this community.

Its provision of health care to the underserved in urban Indianapolis is a lifeline. Its Level I trauma center is one of only two in the state; its burn center is among the best in the country.

These assets have become even more apparent to me following my recent appointment as a trustee to Wishard’s parent, the Marion County Health and Hospital Corp.

We’re also aware of the critical role played by Community Health Network, reaching suburban greater Indianapolis. Community addresses geographic areas that Wishard-Eskenazi Health does not reach, and provides additional services such as cancer and cardiac care. Both furnish primary and preventive care, but perfectly complement each other both geographically and in the specialties in which they excel.

Leaders of the two systems recognize that, to succeed in the future, health systems will have to grow in scope and scale. They will have to focus on preventive care, minimizing catastrophic illness and crisis-based treatment.

This is not about the survival of a corporate bureaucracy; it is about the ability of this community to provide high-quality, affordable services to those most in need, and improve the health of our population.

Some hospitals are reacting by building, or buying other hospitals. That is an expensive proposition and can simply make the care they deliver even more expensive.

But Wishard-Eskenazi and Community have chosen a different path, far less costly to taxpayers, patients and payers. They are entering into a public-private patient health partnership—not merging or consolidating, but collaborating.

In doing so, they will ensure provision of health care to, in particular, the less fortunate; provide services to an ever-growing number who will have access to care; and do a better job of providing preventive care to improve patient health, improve quality of care, and keep costs low.

The partnership model in Indianapolis can serve as a national role model for a health system safety net that ensures reform’s goal of broader access, higher quality and lower costs.

Why is this a big deal? It means Indianapolis is now at the forefront nationwide in finding creative ways to increase access to health care, improve its quality, and reduce its cost. That’s a lot to be proud of, fellow Hoosiers.•

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Daniels, a partner at Krieg DeVault LLP, is a former U.S. attorney, assistant U.S. attorney general, and president of the Sagamore Institute. Send comments on this column to ibjedit@ibj.com.

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