Daniel Burke, MD, CU School of Medicine Associate Vice Chair for Educational Program Development, Family Medicine
According to Daniel Burke, MD, there is a viable solution for businesses to decrease premiums while still providing high quality healthcare for employees.
Dr. Burke, with the University of Colorado School of Medicine’s Department of Family Medicine, met with a small group of Chamber members to talk about how leveraging primary care shows promise as a mechanism to make positive changes in healthcare delivery and costs. Burke is a member of the Colorado Primary Care Collaborative, which has more than 400 members from healthcare, business, government, and academia – all dedicated to advancing primary care by focusing on delivery and payment reform, patient engagement, workforce training, and benefit redesign.
“The U.S. ranks last out of 11 industrialized nations* in cost-related access, efficiency, equity, and healthy lives, according to a study by the Commonwealth Fund,” said Burke. He shared additional statistics about healthcare insurance and healthcare cost increases, as well as how poor health of employees is creating an unsustainable rise in cost – both financially and in productivity of employees – for employers.
According to Burke, by utilizing primary care as the coordinated gateway to healthcare, outcomes will improve and costs will decrease. “Primary care can provide 80 percent of your healthcare needs and can ensure safe navigation through the healthcare system,” said Burke. Studies show that 1 per 10,000 more primary care physicians decreases mortality by 5 percent, and 1 per 10,000 more family physicians decreases mortality by 9 percent.
Statistics show that fragmented care leads to higher costs, and lack of relationship, along with time and focus by specialty care physicians can lead to more tests, false positives, and poorer outcomes. In 2012, the cost of uncoordinated care and waste was $750 billion.**
A viable solution, according to Burke and the Colorado Primary Care Collaborative, is changing to a new paradigm that manages populations instead of treating sickness; collaborates care; uses integrated electronic records instead of isolated patient files; is based on shared risk/reward, rather than fee for service; emphasizes payment for value instead of payment for volume; offers cooperative payer-provider relations instead of adversarial payer-provided relations; and includes joint contracting and coordination instead of “everyone for themselves.”
“We need to follow a patient centered model, where the patient is enveloped by a team, helping them to safely and effectively navigate the health care system while still receiving the resources and care they need to maintain and/or regain their health and reduce their costs,” stated Burke.
*Australia, Canada, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland, UK, and U.S.
**Health Policy Brief: Reducing Waste in Health Care,” Health Affairs, December 13, 2012.