PCF— Health Care Day, part 2

We then traveled to Pali Momi to hear a panel discussion featuring Ben Godsey (PCF '09), President of ProService Hawaii (industry perspective); Hilton Raethel, Sr. Vice President, HMSA (insurance reform/health care perspective); and Chuck Sted, CEO/President, Hawaii Pacific Health (hospital service). The three different perspectives presented showed how deep some of the different interests run, but there was a general sense that each participant sought to find common ground in providing the best plans and care for Hawaii's residents.

Chuck Sted spoke of how health care is transitioning from a cottage industry to a systems-based industry. The goal is to connect all players (patients, doctors, families, clinics, billing) through electronic medical records systems (EPIC). This would take 32 different systems that are currently in use down to 1——> efficiency, cost effectiveness. he referenced the book Good to Great (Collins) to highlight crucial components of this transition:
1) prioritization and managing change well (take care of own physicians and their mental health— family, then community, then work)
2) position leadership
3) quality service, excellence
4) employee engagement

Ben Godsey mentioned how health care costs are currently 17% of GDP and those costs are rising at a rate of 8-10% per year. Hawaii's Pre-Paid Health Care plan (first enacted in 1975) provides a lot of benefits to Hawaii residents, but it also limits the possibilities for innovation. It is a fee for service program (which is a problem these days) but the resulting standard plans in Hawaii offer more than comprehensive plans on the mainland. In his view, the current Affordable Care Act places additional benefits on the Pre-Paid Health Care plans such as drug benefits and by eliminating lifetime limits it will cause costs to rise 13-15% in the first couple of years. Hawaii needs to be careful because its "platinum +" health care plans (pay 94-97% of all costs) may cause companies to move their jobs elsewhere to cut costs. ProService wants to roll out new plans that provide incentives such as going to primary care versus a specialist, preventive care to screen for expensive but more easily detected illness like prostate and colon cancer, and going to facilities that utilize electronic records and evidence-based care.

Hilton Raethel laid out a plan that seeks to:
— minimize duplication of service (communication between primary care physicians and specialists)
— minimize emergency room visits for non-life-threatening conditions (such as urinary tract infections)——> caused by physicians schedules being too packed due to their need to make so much money to cover their liability insurance or just to take advantage of the fee for service structure
— get recommended interventions (prevent conditions like diabetes from becoming life-threatening and thus very expensive; only 10% of diabetes patients in Hawaii get the required interventions)
— increase incentives for outcomes (versus fee for service)

Right now, according to Mr. Raethel, we have fragmentation of care that rewards volume over quality. We need to change the incentives to change the behaviors ——> connectivity, communication, more primary care. We then got a presentation from Dr. Donald Wilcox about how the EPIC system has revolutionized emergency care at his hospitals.

After a tour of the medical facilities to witness the tech advancements currently in use, we then traveled to Shriner's to see their new facilities.
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