Building sustainable healthcare

Shawn West, MD, Chief Executive Officer and Alexis Koutlas, DNP, RN, NE-BC, Director of Integrated Care Management

As we peek out of the COVID-19 trenches, longing to see the daylight on the horizon, we now have an even deeper appreciation for our health, healthcare workers, and health systems at large. The pandemic has exposed many weaknesses in our healthcare system that need to be addressed, from shoring up and protecting our public health infrastructure and workers, to closing the gaping disparities in access to quality healthcare, and the need for adequate tools and support for healthcare professionals to do their jobs.

The latter refers to the sustainability of the healthcare workforce, or what some call the fourth part of the Quadruple Aim. Many are familiar with the so-called Triple Aim in healthcare referring to higher quality, at a more affordable price, with a better patient experience. However, it is becoming clear that unless foundational changes are made to how clinicians spend their time and energy, the burnout and attrition of highly trained and qualified staff will continue to accelerate.

The Quadruple Aim and value-based care

There are several facets of this problem that must be addressed, including the way that clinicians are incentivized and compensated. By shifting to a value-based reimbursement model, providers can focus on patient outcomes and doing what makes clinical/medical sense. If providers are reimbursed by a certain amount to manage a population, they are given more flexibility to work with patients to decide the best way for them to access care – whether that is an in-person appointment, virtual telehealth visit, email communication, or phone call. That is much more patient-centered.

A complementary approach is to use team-based care where several professionals work together to provide care in a way that empowers each professional to work at the top of their license. Whether it is the use of pharmacists to provide medication reconciliation, care managers to make sure patients successfully transition from inpatient to outpatient care and don’t fall through the cracks, or IT tools that allow easy access to relevant data, this approach allocates work to those that are best suited, and lets doctors and patients do what they both want to do–spend time together to stay or get healthy.

Change is hard... but necessary

This may seem like a lot to tackle, but it is possible and necessary if we want to have a sustainable healthcare system. Change is hard, it takes time and patience, but change is needed. Maybe one positive out of this horrific pandemic is that more people now recognize the importance of their health, healthcare workers, and the overall system of care. Our commitment, post-pandemic, should be to build on the lessons we have learned to do things differently in support of better outcomes for patients and our providers. 

To accelerate this change, providers can inquire about participating in Embright's network, employers can implement value-based care networks in their employee benefit programs, and employees can suggest value-based care options to be included in their benefits offerings. Our opportunity is now to learn, grow, and be better. And this change starts with each one of us.