Symposium Today

Thursday, July 29, 2010

Welcome to Symposium Today, a daily summary of news, quotes, insights and media coverage from the Colorado Health Symposium.

In this issue:
Former Surgeon General promotes prevention
Fixing a broken health care system
News coverage and social media
Highlights from Thursday’s Symposium events
Next up: Friday, July 30
Speaker slides available online

Quotes of the day:
“Making [patients] bills bigger has been a manifest goal for our industry for quite some time now. It’s a game that can’t be won, yet it’s exactly the game we are playing with the fee-for-service model.”

— Dr. Jay Want
President and CEO,
Physician Health Partners LLC

“We need to embrace prevention and optimal health. Otherwise, all that’s going to happen is we’re going to pay more with each administration.”

— Dr. Richard Carmona
17th Surgeon General of the United States

“When you discover you’re on a dead horse, the best strategy is to dismount.”

— Michael Soman
President and Chief Medical Executive,
Group Health Permanente

Keynote highlights: Former Surgeon General says prevention is key
“The value proposition in health care needs to be about delivering the best care to the most people with the least costs,” declared Dr. Richard Carmona, the 17th U.S. Surgeon General in Thursday’s keynote address at the Colorado Health Symposium. Carmona, who issued the definitive report about the dangers of secondhand smoke and warned about obesity as “a national security threat,” said prevention is the key to the sustainability of health care system.

“No matter what comes out of this health care transformation, the only way we’re going to turn this around is through prevention,” he said. “We’re spending $2.5 trillion on health care — 75 percent of which is for chronic disease, most of which is preventable. If you were the CEO of a company and told the board you lost 75 percent of its earnings, how likely do you think it would be that you’d stick around?”

Before things improve, the emphasis needs to shift from what Carmona characterized as “sick care” to true “health care.” “We have data and science and know where we need to go; what we lack is the political will to do what needs to be done,” he said. He cited many paradoxes in U.S. health policy, including how the government subsidizes tobacco and won’t provide adequate prenatal care to prevent birth defects. Carmona also talked about the politics of being Surgeon General and crafting effective health policy despite Washington partisanship.

A high school dropout who grew up in the mean streets of New York before serving as a Green Beret and joining the medical profession, Carmona called disparities in the health care system “an embarrassment to the richest country in the world.”

Today’s discussion: Fixing a broken health care system?
Putting patients at the center of health care, with an emphasis on results over services, will stem the trend of rising costs and declining patient satisfaction, said experts speaking at Thursday’s Colorado Health Symposium. However, the plenary speakers agreed making the shift to a “patient-centered” system will require a concerted effort from health professionals, participation from patients and experimenting with new approaches to see what works.

Addressing the question of Thursday’s plenary discussion (“It’s Broke, How Do We Fix It?”), Dr. Jay Want, president and CEO of Physician Health Partners LLC, said compensating health care professionals for what they do rather than the results they achieve is largely responsible for what has become expensive, ineffective clinical care. Over the years, Want said the health care sector has mastered the art of drawing money from third-party payers where economic harm can be hidden or diffused – often at the expense of patients.

Harold Miller, executive director, Center for Healthcare Quality and Payment Reform, concurred with Want, saying America’s delivery system is lopsided. “The system rewards bad outcomes,” Miller said. “No one gets paid if patients stay healthy.” Miller called for integrated approaches such as “medical homes” that streamline primary and specialty care.

John Rother, executive vice president of policy and strategy for AARP, said while health professionals should lead the charge in improving health care, patients also need to work to improve the system. “We all bear responsibility for the breakdown,” Rother said. “It’s not all about doctors and hospitals. About half of the Medicare patients don’t bring questions with them to a doctors’ visit. People leave the office feeling confused about what they should do.” He urged clinicians to promote more patient engagement. “We need a change in culture, reinforced with clear information. ... The key is to be proactive rather than reactive about managing patient health.” Rother also said giving patients better incentives for making value-based choices also could rein in costs.

In revamping the system, Jason Hwang, M.D., M.B.A., executive director of health care for the Innosight Institute, said the health sector should look to other industries to improve quality and control costs. Hwang, co-author of “The Innovator’s Prescription: How Disruptive Innovation Can Fix Health Care,” cited the computer industry as an example of a good role model for health care. In the development of personal computers, he noted early tech users accepted limitations and tradeoffs for technology which became better and more affordable. “In any market, you can graph performance improvement over time.” But in order to make needed changes, Hwang said all parties in health care need to embrace “disruptive innovation,” wherein ineffective methodologies are replace over time with more effective ones.

Michael Soman, president and chief medical executive of Group Health Permanente, said that embracing innovation paid off for the consumer-governed, nonprofit health care system based in Seattle. Soman quoted a colleague in identifying what many health practices need to do to improve quality and control costs: “When you discover you’re on a dead horse, the best strategy is to dismount. We dismounted.” After exploring various different approaches, Soman said Group Health Permanente came to the conclusion that “more and more capable primary care equals lower costs and higher quality.” As a result, ER visits and doctor visits have dramatically declined. Soman said investing in health information technology and educating health providers pays off. He acknowledged changing the way health care is delivered is daunting, but essential. “We’re in a struggle with American medicine,” Soman said. “The [current] system will implode if we don’t fix it. We can only do that if we work together and learn together, with humility, with open minds, with unflinching focus. We can do this.”

News coverage and social media
On Wednesday, Rocky Mountain PBS's Colorado State of Mind taped an episode at the Colorado Health Symposium. The show, which airs Friday, July 30, features Dr. Mark Wallace, president of Northern Colorado Health Alliance and executive director of the Weld County Department of Public Health & Environment; Dr. Jay Want, president and CEO, Physician Health Partners; Dr. Michael Soman, president and chief medical executive, Group Health Permanente; Gretchen Hammer, executive directrtror, Colorado Commission for the Medically Underserved. The topic is “What Will Health Care Reform Look Like?”

 Follow Us on Twitter @HealthSymposium
Follow along for Symposium tweets. We are using the #10CHS hashtag for this year's Symposium posts. You can tag your own Symposium-related tweets with the #10CHS hashtag to join in the conversation. Search on #10CHS using Twitter Search to keep up with a running list of all Symposium-related tweets.

 Visit the Colorado Health Symposium Blog
We will post summaries of each speaker’s presentation will be posted during the Symposium. These perspectives are a great way to experience each plenary session. We encourage you to add your two cents to the discussion by commenting on the postings.

 We’re Live Streaming Video on Ustream
Many plenary session speakers from the Colorado Health Symposium will be featured on live broadcasts. You can add your input using chat and view the social stream to link up with Twitter.

 Connect with us on Facebook
Stay updated on Symposium happenings by "liking" our official Facebook page. We encourage you to share, comment on and "like" the Foundation’s Facebook posts.

 View Speaker Interviews on YouTube
Get behind-the-scenes with the Symposium on YouTube by viewing selected speaker video clips during the event.

Oxford-style debate prompts spirited discussion, laughs
Some of the sharpest minds and most articulate voices on health policy squared off Wednesday over one of the most contentious issues of the day: “Does Obamacare give the U.S. government too much control over America’s health care?” The often humorous, always civil debate featured Stuart Butler of the Heritage Foundation, a Washington-based conservative think tank, and Colorado's Attorney General John Suthers vs. former Colorado Gov. Richard Lamm and journalist/author T.R. Reid. Regina Kilkenny, senior medical education officer at the Colorado Health Foundation, contributed a blog posting on the event for the benefit of those who were or weren’t there.

Other highlights from Wednesday and Thursday’s Symposium can be found on the Symposium website.

Next up: Friday, July 30
7 a.m. – Breakfast with Colorado Health Foundation Senior Program Officers
8:15 a.m. – Keynote address: Elliott S. Fisher, M.D., M.P.H.
9:15 a.m. – Plenary discussion: “You Get What You Pay For: Incentives and Payment Reform”
11:20 a.m. – Panel discussion
12:30 p.m. – Closing remarks

View full agenda

Speaker slides available online
Looking for great statistics or tidbits from this year’s Colorado Health Symposium? Many speakers’ PowerPoint presentations will be posted online. [learn more]