NCHC CEO, Michael Costa, wrote the following op-ed which was published on VTDigger and discusses health care reform throughout the uncertainty of COVID-19.
Health Care Reform Can Make an Uncertain World More Predictable
The COVID-19 lockdown reinforced two major health care reform goals. First, Vermont needs strong and innovative partnerships with community organizations to make sure Vermonters are physically healthy, mentally healthy, well nourished, well housed, and financially secure. Second, Vermont needs a health care system that can promote health in our communities no matter how many patients walk through the doors of our health care institutions.
Community partnerships are more important than ever. Hunger, despair, and economic insecurity have an enormous impact on health. Each car in line, waiting for miles and hours to pick up food, tells a story of the precariousness of our population’s health and well-being. Vermont’s health care organizations know this truth, and were collaborating with the rest of the health and human services care continuum to act upon it when COVID-19 hit.
During the lockdown, Vermont’s health care system faced the greatest challenge in its history. Hospitals reconfigured space, redeployed staff, and managed a disruption of the global supply chain to meet the challenges of a once in a century pandemic. Hospitals were not the only organizations caught in this storm. Primary care providers, home health and hospice agencies, and designated mental health agencies changed their operations rapidly, encouraging remote care using technology, to continue to serve as the first line of defense to keep people healthy and out of the hospital. Yet, keeping people away from our hospitals and clinics to promote safety created real financial insecurity. The fee for service health care model, getting paid only when patients come through the door, attached an unprecedented financial crisis to a global health crisis. The solvency of our health care system was threatened just when we needed these institutions most. Monthly fixed payments, like those contemplated by Vermont’s All-Payer ACO Model and being tested in other states, could have reduced the risk to innovative partnerships and mitigated the financial crisis thrust upon health care organizations.
Health care reform is important because it pushes us to transform our health care system from one that incentivizes more care to one that focuses on the quality of our community’s health, addressing the underlying drivers of poor health. A more predictable and durable funding model promotes innovative partnerships and protects access to care even during our darkest hours. Health care reform that brings a predictable and durable funding model would allow health care organizations to provide the care and partnerships the community needs, where and when they need it, no matter how many people walk through the doors of a health care organization. This ought to be a key lesson from the present crisis for health care leaders and policymakers and, if not, it will be an opportunity cost to add to the terrible human and economic costs of COVID-19.