Providers and payors are broadening their definition of care delivery to address issues like housing and nutrition programs, though they may not agree on how well-equipped the healthcare industry is to solve these problems.
Speaking at a Washington, D.C. seminar hosted by Duke University’s Margolis Health Policy Center, Geisinger Health System President and CEO David Feinberg, MD, gave his perspective on how private companies can take the lead healthcare changes.
Feinberg argued that healthcare leaders shouldn’t wait for transformation to come from federal regulators and lawmakers.
“I think our industry is so screwed up and it’s ripe to be disrupted,” he said. “Either we do it or some Stanford dropout in a black turtleneck is going to knock out our whole business.”
Geisinger is both a provider and payor, giving it additional opportunities for integration to drive down costs. While in terms of traditional care delivery, that’s meant encouraging relationships with primary care physicians and their patients, Feinberg also mentioned approaches beyond the usual settings—like offering food to diabetic patients and seeing benefits to their weight and blood pressure as a result.
“If this was a pill, it would be a miraculous pill,” Feinberg said. “We have patients who we spent $220,000 in four years before we started giving them food. In the year they’ve been in the program, our medical costs are $1,200.”
Feinberg didn’t consider these individual initiatives innovative, but they do require a change in mindset from a health system. With the reach and resources of a large organization like Geisinger, Feinberg said it could be a “convener,” bringing together existing nonprofits in a more coordinated effort to improve the health of a population.
“When you sit down and talk to folks who are on [food stamps] or folks who are getting Section 8 housing, they’ll tell you how crazy the system is,” Feinberg said. “So we can bring that together and make it easier for one-stop shopping.”
Feinberg himself mentioned putting these ideas into action required workers with skills new to healthcare, like machine learning, artificial intelligence, adding “no one really knows how to do this."
His co-panelist, Molina Healthcare President and CEO J. Mario Molina, MD (who has fired from those roles less than a week after the event), had a slightly different take. He agreed there were areas where healthcare organizations could help patients with the “convener” mentality with issues like housing—which the University of Illinois Hospital has already experimented with for frequent emergency department visitors.
Overall, however, he questioned whether the healthcare industry can make an impact on the larger social determinants of health.
“We look to the healthcare system to fix those problems. It really can’t,” Molina said. “Obesity is not something you’re going to cure. It’s a public health issue. It really is.”