Spirited Discussion at the Kentuckiana Health Collaborative Annual Conference
by Tom James, MD
Efforts to improve access to health care in Louisville have had strong history. In the early 1990s, then Governor Brereton Jones established a Task Force on Health Care Access and Affordability. Through a series of town hall and corporate conversations, the Commonwealth embarked up a series of reforms. However, because of the escalating health care costs and issues with reimbursement schemes, much of the ambitious program was defunded. But concerns persisted. Louisville hospitals and other organizations contracted with the Lewin Group to do an analysis of health care services, access and policies. This national consulting organization released its findings in 2003. Just two years earlier, the United Auto Workers( UAW) and Ford had made Louisville one of the eight cities they focused on to improve access to care for the community, especially for their employees. The Lewin Group’ s findings helped ignite the UAW / Ford Community Health Initiative to become a true business-health collaborative. While Ford’ s funding has ended, the Kentuckiana Health Collaborative( KHC) continues to work with health systems, physicians, insurers, pharma and employers focusing on providing education to be disseminated. A recent example was an immunization fact sheet that employers can use to help overcome vaccine hesitancy.
Annually, the KHC holds a large conference that includes local and national leaders in the health care space. This year the conference was held on October 14th at the UofL Shelby Campus. Executive Director Natalie Midaugh curated a remarkable group representing different components of the American health care system.
The keynote speaker was Dr. Tracy Wang, who is the Chief of Comparative Effectiveness Research( CER) for the public-private funding organization Patient Centered Outcomes Research Institute( PCORI). This organization provides funding for pragmatic research that can help people make informed health care decisions. Dr. Wang is a cardiologist on the faculty of the Stanford Medical School. From her position at PCORI and as a
clinician, she looks at the variations in health across the country and the barriers to appropriate care. The goals of the research funding by PCORI are:
· Prioritize preventive care
· Improve high-quality care where patients and caregivers live
· Accelerate the move of research results into clinical practice
· Engage patients and community stakeholders to understand health care value in context.
Most physicians are aware of the common causes of disability such as heart disease, diabetes, stroke, COPD and musculoskeletal disorders. As a profession we are aware of the preventable causes of earlier death, including dietary risks, tobacco, obesity, hypertension, air pollution and sedentary lifestyle. However, she pointed to the non-medical opportunities that are missed. These may contribute around 30 cents to each health care dollar.
Adequate primary care is under threat as many primary care physicians report burnout, with primary care shouldering the bulk of government and insurance quality programs. Around 46 % of family
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Printed with permission from Dr. Wang
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