George Halvorson, CEO of Kaiser Permanente, began his address at the HFMA conference with an attention-grabbing declaration. “It doesn’t matter what the Supreme Court does,” he told a jammed room of several thousand attendees, referencing the forthcoming decision on the Affordable Care Act. “We still need to make health care affordable.”
Halvorson detailed the financial challenge facing the industry, laying out multiple statistics on cost drivers. A very small percentage of patients account for a vastly disproportionate share of the cost, he said. “Ten percent of the population drive 80 percent of the cost,” he said, noting that chronic conditions are the biggest factor in the runaway expenses threatening to derail the industry.
Good data and robust connectivity among providers and patients are the prerequisites for any cost reduction effort, Halvorson contended. He described the electronic health record in play at Kaiser, which has invested $4 billion in clinical I.T. Kaiser’s EHR numbers are formidable. Its Epic Systems database contains 10 million records. Patients can book appointments, communicate with their caregivers and view their charts online via a portal. The integrated delivery and payment system delivers 60 million lab results electronically every year and conducts 10 million annual “e-visits,” a number which Halvorson said will only grow.
To tackle chronic patients, Kaiser has embraced team care, pushing out care reminders and alerts to various caregivers and sharing information across the board. Kaiser’s a provider and health plan rolled into one, an arrangement Halvorson says is superior to the conventional third-party payer structure of the industry. “The Kaiser Permanente model is much easier to coordinate. It is easier, better and more convenient to deal with the issues in one tent.”
Kaiser’s electronically enabled care delivery has resulted in marked improvements in clinical outcomes, he said, citing HIV death and inpatient sepsis infection rates as well below national averages. Halvorson offered no reimbursement formula for national health reform, but he did advocate universal coverage. Merely embracing clinical I.T. and related care support protocols would all but end the nation’s financial woes with chronic disease management, he contended.
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