Callender: Our country’s current health care system is challenging. The cost of care is too high for patients, employers, and other key stakeholders. People in the United States experience the worst health outcomes overall of any high-income nation. In addition, the overall health care system, which is also difficult to access and navigate, is not designed to address all the factors that impact a person’s health and well-being, including access to nutritious food, safe housing, or transportation to a doctor’s appointment.
As an employer and health care provider, we have a unique view of these issues.
We see the impact that a challenging health care system can have on individuals and families, as well as employers who are doing all they can to alleviate these challenges and support a healthy workforce.
Despite all of this, there is good news.
The industry is primed for innovation, and there is tremendous opportunity for health systems to partner with community leaders, business leaders, and government and social service agencies to lead a health care system transformation. Memorial Hermann proudly has taken on this challenge in our region, and we are embracing our roles as employer and health care provider to deliver greater value for our patients, employers, and the broader community.
Bellow: The current state of health care and the workforce extends beyond traditional health insurance to encompass a broader concept of wellness. It's about fostering a supportive work environment and a positive company culture. A workforce that feels valued and content is inherently healthier and more productive. Therefore, our focus extends beyond mere insurance benefits. In today's competitive landscape, attracting and retaining talent hinges on offering comprehensive benefits and a conducive work environment. This includes provisions such as family leave, maternity leave, and robust employee assistance programs that address mental, physical, and emotional health needs. By prioritizing employee well-being, we aim to cultivate a workforce that thrives both personally and professionally.
Spann: From a macroeconomic perspective, we define value as the relationship between the quality outcomes of care and the associated costs. Despite spending more on health care than any other nation globally, the U.S. lags behind in terms of quality compared to other wealthy countries, rendering our health care system's value relatively low. Moreover, patient experience often falls short, compounded by the significant fragmentation of care within our system. Care has become increasingly transactional, losing its relational aspect, which is concerning. Another pressing issue is the rampant burnout among health care professionals, with over 50% of physicians reporting burnout in repeated surveys. This can be attributed to factors such as regulatory burdens, electronic medical records, and the pressure to deliver more while maintaining high quality. Furthermore, the health care workforce faces a looming shortage of physicians. Efforts are underway to address this by expanding medical training programs to ensure an adequate supply of physicians in the future.
How Does Memorial Hermann Define Value and Why This Is Important for the Overall Health of Houston’s Workforce?
Callender: I’d like to begin by saying it’s important to define what value is not. Value is not a race to the bottom to get the lowest price for a particular procedure or service. Value also is not only pay-for-performance. Pay-for-performance, or pay for outcomes models, are an element of a value strategy, but they are not the whole strategy. Value, and more specifically, high-value care at Memorial Hermann is about achieving health care’s quintuple aim: enhancing employee and physician well-being; prioritizing the patient consumer experience and engagement; promoting health equity and improving access to care; delivering coordinated, collaborative care focused on quality, outcomes, and disease prevention; and reducing the total cost of care.
Our goal is to enable the entire health system to create more value for patients and populations; that is, delivering the greatest outcomes at an optimal cost, creating exceptional experiences for our patients and a fulfilling work environment for our workforce, and improving health equity in the communities we serve.
In addition, while Memorial Hermann serves the Greater Houston community as a health care provider, we are also one of the largest employers in the region. From that employer perspective, when addressing this region’s workforce, it's evident that simply providing insurance benefits isn't sufficient when it comes to recruiting, retaining, and caring for a top-tier workforce. Increasingly, health care providers and business leaders agree that we must prioritize the holistic wellness of individuals, focusing on prevention of illness, cultivating emotional well-being, and promoting timely access to care. Collaboration between the business community and the health care system is crucial for creating value and sustaining a healthy workforce, which underpins a healthy economy from which we all benefit.
The industry is primed for innovation, and there is tremendous opportunity for health systems to partner with community leaders, business leaders, and government and social service agencies to lead a health care system transformation. Memorial Hermann proudly has taken on this challenge in our region, and we are embracing our roles as employer and health care provider to deliver greater value for our patients, employers, and the broader community.
Within the Business Community, What Are the Broader Challenges You and Your Peers Have Encountered in Managing Employee Benefits and Health Care Costs?
Bellow: One of the primary challenges we face in managing employee benefits and health care costs is their consistent annual increase. Balancing our budget with the benefits we can afford to provide is crucial. Prioritizing wellness in the workplace is paramount, as it directly impacts employee health and productivity. Investing in initiatives that promote a healthy work environment is essential. This includes measures such as optimizing air circulation, minimizing touch points at entry and exit points, and ensuring access to fresh snacks and water. Additionally, sponsoring regular office events, such as morning fruit smoothies and afternoon coffee bars, can contribute to fostering a vibrant and energized workplace atmosphere. Creating a workplace where employees feel valued and supported not only enhances morale but also contributes to overall productivity. It's imperative to view this as a holistic investment from a corporate perspective, recognizing the long-term benefits of prioritizing employee well-being.
How Can Major Health Care Systems and Local Employers Foster Collaboration and Innovation To Address the Diverse Health Care Needs of the Greater Community?
Spann: To effectively address the diverse health care needs of our community, it's imperative that we establish shared goals focused on enhancing value, lowering costs, improving outcomes, and enhancing both patient and provider satisfaction. Central to our approach is the concept of health equity, which entails ensuring that everyone has an equal opportunity to achieve optimal health. We acknowledge the presence of numerous health inequities within our population, and to mitigate them, we must address the underlying social determinants and non-medical drivers of health. This proactive approach involves tackling these issues upstream, before individuals fall ill, thereby preventing downstream disease, mortality, and associated costs.
How Do Innovative Models of Care Delivery Such As Community-Based Care and Collaborative Practice Contribute to Health Care Equity by Addressing the Unique Needs of Diverse Patient Populations?
Spann: I am a strong proponent of a collaborative approach to addressing health inequities within communities. This model entails working closely with communities facing significant health disparities to identify and tackle these challenges. Central to this approach is the provision of health care services at the community level, with a focus on primary and behavioral care. Additionally, it's crucial to acknowledge the vital role of social care in addressing the underlying non-medical factors influencing health outcomes. To effectively address these issues, we must establish collaborative networks that bring together medical and social care providers. By working in tandem, these providers can address the multifaceted needs of patients comprehensively. Furthermore, the implementation of a robust IT platform is essential to facilitate the seamless exchange of patient information and enhance care coordination. I firmly believe that by achieving these objectives, we can make significant strides in improving the overall health of our population.
How Can Businesses Effectively Address the Cost of Health Care and Health Insurance for Their Employees? And What Are Health Systems Like Memorial Hermann Doing To Promote Cost Transparency and Reduce the Cost of Care for Businesses and Consumers?
Callender: We prioritize transparent communication with individual patients regarding their health care plans and coverage as well as payment options. It's essential to be upfront and honest, ensuring that they feel comfortable asking questions about costs without hesitation. True transparency means highlighting the likely specific impact for each patient, including their out-of-pocket expenses.
Reducing the overall cost of care takes a collaborative effort. This starts with aligning on a shared definition of value and incentivizing and rewarding the right things so that doctors, hospitals and health systems are supported in their work to integrate, share data, and prevent hospitalizations – all the things that are necessary to bring down the total cost of care and improve health outcomes.
How Can the Leaders Within Academia, Business, Community, and Health Care Better Partner To Create Actionable Programs To Support Healthier Communities?
Spann: Leaders can foster collaborative and constructive partnerships by establishing shared goals and addressing challenges together. This approach requires an upfront investment but is essential for creating actionable programs to support healthier communities. Evidence from global studies suggests that investing in upstream prevention and addressing adverse social determinants of health yields long-term benefits. Health care economists argue that the savings generated downstream from these investments outweigh the initial costs. Ultimately, this results in lower overall costs and improved health outcomes, which translates to better value for communities. By prioritizing prevention and addressing social determinants, leaders can create sustainable solutions that benefit both individuals and society as a whole.
Where Do You See the Conversation Around Health Care Value Going in the Future?
Callender: I believe fostering more dialogues like this is crucial. As health care providers and employers, it's imperative that we continue these discussions, centering our efforts on delivering value to patients, families and broader communities. Collaboration among health care providers, community and business leaders, educators, social service agencies, and governmental bodies is essential to address longstanding disparities. We must heed Dr. Spann's advice to identify specific targets and aim for tangible progress. While the challenges ahead may seem daunting, with concerted effort and collaboration among the organizations represented here, we can undoubtedly make a meaningful impact. Ultimately, our collective goal is to deliver high-value care and, in doing so, improve the health and well-being of everyone in greater Houston.
Final Thoughts
We believe fostering more dialogues like this is crucial. As health care providers and employers, it's imperative that we continue these discussions, centering our efforts on delivering value to patients, families and broader communities. Collaboration among health care providers, community and business leaders, educators, social service agencies, and governmental bodies is essential to address longstanding disparities. We must heed advice to identify specific targets and aim for tangible progress. While the challenges ahead may seem daunting, with concerted effort and collaboration among the organizations represented here, we can undoubtedly make a meaningful impact. Ultimately, our collective goal is to deliver high-value care and, in doing so, improve the health and well-being of everyone in greater Houston.
About the Authors
This article was originally published in the Houston Business Journal in June 2024.