Hartford Business Journal

www.HartfordBusiness.com • January 7, 2019 • Hartford Business Journal 21 OTHER VOICES CT can be U.S. leader in curbing healthcare costs By Eric Galvin and Jess Kupec H ealth care is expensive in the Nutmeg State. The reasons are plentiful, but a more informed and better coordinated utilization of our current system could help lower healthcare costs and improve outcomes, making it more affordable for everyone. Connecticut is home to industry- leading healthcare resources, services and expertise, but the costs of using our world-class healthcare ecosystem are unsustainable under our current fee-for-service payment formula. We can do better. Access to quality, affordable health care is attainable and is being mod- eled in an indus- try collaboration currently under- way in our state. The search for a better approach started a couple of years ago when the leadership of ConnectiCare and St. Francis Healthcare Partners began taking a closer look at the payer-pro- vider relationship. We quickly identi- fied some significant (and frustrating) challenges for consumers. The indus- try as a whole mainly operates on a fee-for-service model; you visit your doctor and you pay for the visit. Seems simple. However, this relatively simple ar- rangement too often sets in motion a confusing array of prescribed, but un- coordinated, interactions with provid- ers of supporting products, servic- es and payments. This leaves the consumer to integrate each of these pieces into a coherent outcome. It is not sur- prising that the process often leads to duplicative or unnecessary procedures with lower quality outcomes and higher costs. We saw a window of opportunity to test a better approach to the way payers work with providers; one that is collaborative, reduces inefficiencies and duplication of activities, shifts the focus to the value of care, and enhanc- es the patient experience. Along with ConnectiCare, St. Francis Healthcare Partners and other industry participants, the Connecticut Health Council recently formed the Value Based Relationships work group. The group consists of health plan represen- tatives and provider systems, doctors, pharmaceutical companies, consumer advocates, insurance brokers, various social-services providers and others. Working together and leveraging our collective expertise, we can estab- lish integrated models of care based on comprehensive metrics and quality outcomes, rather than continue to rely on the inefficient, disintegrated fee- per-healthcare transaction model. Our goal is to allow the healthcare consumer to pay for the quality of out- comes rather than the number of indi- vidual services a system provides them. Our pilot project is currently focus- ing on Type 2 diabetes, and how each group member is involved with the care process for treating that disease. Whether a group member is a primary care physician, health plan, endocri- nologist, or an employer of a potential patient, we each have roles, responsibil- ities, products and services that can be analyzed for impacts and efficiencies. By beginning with this single disease focus, the work group is able to approach the best outcome creatively and as an in- tegrated system rather than as individu- al stakeholders. This collaboration allows us to test various approaches in improv- ing how and where care is delivered. So far, we are encouraged by the level of interest and cooperation of industry partners. ConnectiCare and St.Francis Healthcare Partners could have chosen to address this challenge alone, but the better solution for Connecticut is to make this approach scalable for all healthcare providers across the state. We need other health insurance carri- ers and healthcare providers to join us, to help us demonstrate why this model is good for consumers and businesses alike, and to show the country that there is a different way. A better way. The more voices and collaboration we can enlist, the better our chance of success for controlling costs and improving outcomes for patients. We urge all interested parties to join the effort. Eric Galvin , president of health insurer ConnectiCare, and Jess Kupec, president and CEO of St. Francis Healthcare Partners, co-chair the Connecticut Health Council's Value Based Relationships work group. HARTFORDBUSINESS.COM POLL LAST WEEK'S POLL RESULT: Did the Malloy administration hurt or help Connecticut's economic competitiveness? NEXT WEEK'S POLL: Should Connecticut adopt a paid family medical leave program? To vote, go online to hartfordbusiness.com BIZ BOOKS Tips for change management By Jim Pawlak "The Great Manage- ment Reset: 27 Ways to Be A Better Manager" by Leslie Kaminoff (Morgan James Publishing, $16.95). The "Change Management" chapter stands out because change disrupts the status quo. To put change-disruption in context, make a list of what, how and who are af- fected by each of these internal events: budget adjustments (up or down), organizational growth or decline, staff turnover (not only in your department but in those involved in your projects), deadline and priority shifts, scope creep and new procedures. Your lists point to the need to have viable and flexible plans in place to deal with the "people" issues of change (e.g. shock, rejection, expectations, ac- ceptance, etc.). The four Cs to manag- ing the people-side of change are: 1. Communication — Tell people what's happening, "how it's going to affect them and what life is going to look like on the other side." As the pro- cess unfolds, keep people updated. 2. Community — Change often re- sults in taking the eye off the organi- zational goal. Emphasize that change always presents an opportunity to explore new ways to achieve that goal. People's acceptance increases when they see that the manager has created a sup- port system (e.g. resources, revised processes, assignments/ projects, time- lines, etc.) for implementation. 3. Camaraderie — By adopting a "we're in this to- gether" approach to exploring those new ways, staff will continue connecting with each other and the tasks at hand. Encourage communication among the staff and feedback, which can be used to feed- forward. 4. Coaching — You need to rec- ognize where individuals are on the change buy-in scale and let them ex- press their views and concerns. You're responsible for helping them deal with "what's happening" and their roles. The bottom line: It's up to manag- ers to help staff "turn the page." 87.1% Hurt 12.9% Helped READER COMMENTS: "Policies have hurt the ecosystem needed to draw talent, youth and business. High cost of living is the result of all of the various overhead items that get put on the backs of all. People are opting for other options with less risk of being the meal ticket for CT's financial issues." "His economic failures pushed CT to the end of the list of robust state economies making the state totally uncompetitive with the rest of the Nation." Eric Galvin Jess Kupec Jim Pawlak Book Review

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