This week I attended the Annual Meeting of the Massachusetts Hospital Association (MHA), where most of the Massachusetts hospital CEOs and execs get together to discuss topics of common interest. The major topic this year was the transformation of the healthcare system, its costs and its payment models.
Of specific import to the hospitals, as presented by Kenneth Kaufman in his keynote presentation, was the evolving change from primarily inpatient care to outpatient care, with greater emphasis on improving post-discharge care transition and patient outcomes and reducing unnecessary costly readmissions, the emergence of alternative care providers (e.g., CVS Minute Clinics), and the clear momentum towards Web and mobile-based provision of care. (The latter is of great interest to iGetBetter, as that is exactly what we do.)
Part of the discussion, of course, was about the cost, and that the US has an expensive healthcare system compared to the rest of the world. It is no secret that Massachusetts has an expensive hospital system compared to the rest of the US. One of the reasons is that many hospitals in Massachusetts are world-renowned teaching and research hospitals, and they charge Medicare and private payors more than other hospitals in part to fund their teaching and research activities. This is not just a Massachusetts phenomenon - it occurs across the US - although we have the largest such cluster. One speaker pointed out that this is not the case anywhere else in the world, and that the US produces more than 90% of the medical innovations in the world.
One can debate if this is the best way to fund medical research and innovation, a way that significantly contributes to the high cost of “ordinary” healthcare in the US. But one can’t debate the positive results from which we all, including the rest of the world, benefit. The teaching and research hospital execs are wrestling with how to keep the “good” while cooperating in lowering “ordinary” healthcare costs. Perhaps direct Congressional funding of medical teaching, research and innovation is an option, but this is not easy in today’s political climate in the US.
At the breakfast meeting this morning we had a speaker that brought all of this into sharp, human focus – Jeff Bauman, Boston Marathon bombing survivor. He has published a book, "Boston Stronger", and started by reading to us the first chapter entitled simply “The Bomb”. It was stunning. When he finished, there was complete silence, immediately interrupted by a standing ovation. I looked around – I did not see a dry eye.
Jeff brought a personal human dimension to the carnage as well as to the extraordinary efforts of the first responders and medical teams that treated the wounded. Over 200 wounded persons were speedily and skilfully attended to by the first responders, and then transported to five – yes, five – different trauma centers at teaching and research hospitals within a couple of miles of the Marathon finish line in downtown Boston. Not a single person who was alive when transported to one of these hospitals died, despite some horrific injuries. These were extraordinary outcomes made possible by the expert medical teams and special resources available at those hospitals. And these extraordinary outcomes continued over the ensuing months as the wounded received some of the best rehab in the world.
As Jeff Bauman stood before us on his high tech microprocessor-controlled prosthetic legs, I thought how unlucky he and the other 200+ victims were to be so horribly victimized, but at the same time how lucky they were that this happened in Boston. And as I looked around at the faces of the hospital execs who were inspired by Jeff’s story while at the same time wrestling with the transformation of the healthcare system, I thought I hope while fixing the parts of our healthcare system that need fixing, we can preserve what is really good and special about it .
Win Burke, President and CEO