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As a physician who has practiced medicine for more than two decades, I have had countless patient conversations about how to achieve the best medical outcomes. Access to care and the affordability of such care, while current exam-room topics, are far fromnew concerns.
I have deliberately chosen to continue seeing patients while serving as the only physician-CEO among Indiana’s largest health care systems. Having an exam-room perspective is both informative and motivating. With a doctor’s viewpoint, I experience just how vital it is to tackle issues such as health care access and affordability. As a business leader with both an MBA and (within months) a doctorate in health care administration as well as extensive experience in transformative care, I know these dilemmas are actually opportunities awaiting collaborative actions.
The financial landscape in health care is becoming increasingly complex. One recent study by a respected national consulting firm found Indiana hospitals and systems are seeing increasing numbers of uninsured and charity care patients, above the national averages. New federal and state policies are likely to lead to even more uninsured Hoosiers in the years ahead.
Meanwhile, government payers such as Medicaid and Medicare — which account for the majority of the care we provide at Community Health Network — do not compensate us proportionately to actual care costs. Growing resistance from commercial insurance companies, along with rising supply and labor costs, create additional health care hurdles.
Analogous to families examining and planning their financial situations, those who provide care must ensure the money coming in covers the expenses going out. With the challenges from all directions, health care systems are being forced into tough choices — for example, more than a dozen Indiana hospitals have had to close their maternity units in the past several years.
As bleak as that picture might sound, I look ahead with optimism. We at Community have ideas that have already proven successful in lowering health care costs for Hoosiers. The solutions reflect our mission statement: “Deeply committed to the communities we serve, we enhance health and well-being.” That requires providing well-coordinated access not just to treatments but also to services that can help people stay healthy.
New concepts are bearing measurable gains. For example, the partnership between Community and one local employer has had such a positive impact on costs that the employer chose to give its employees a year with zero health insurance premiums. And a recent state government report found that the commercial prices at Community and Indiana’s other large nonprofit health systems are significantly better than targets set by the state and have been falling for three years in a row.
Transformational thinking can successfully address Indiana’s health care challenges, but the burden can no longer be placed solely on the shoulders of those delivering the care. The most dramatic progress will require true partnerships and collaborative conversations involving all who influence how and what Hoosiers pay for care — not just hospitals and systems but also insurance companies, government payers, employers, policymakers, pharmaceutical companies and other suppliers. There’s not a one-size-fits-all solution, so success will have less to do with mandates and more to do with partners working together in good faith.
The problems we must solve together are vast and complex, and the solutions must be broad and systemic. Amid that big-picture reality, I feel blessed that my medical practice regularly puts me in that exam room face-to-face with one patient at a time. For me, those doctor-patient interactions are humble reminders of why we in health care are really here, why we do what we do, why we must always work to do better and how the overall system can improve.
I am confident in a bright future and am eager to move forward with ideas combining a careful clinical perspective, a pragmatic business mindset and a compassionate focus on lifting Hoosiers’ well-being and quality of life.•
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McGill is president and CEO of Community Health Network in Indianapolis.
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