Where prescribed burns are needed
Said Crane: “What in our forest should be viewed as underbrush and deadwood? What serves as the fuel to magnify these issues, hindering innovation and improvement and leading the United States to perform so poorly when compared with other high-income countries?”
He pointed to the following issues:
Misaligned incentives. One statistic that illustrates the deadwood in the U.S. healthcare system, Crane said, is the prevalence of MRIs: 40 per 1 million people, or 60% more than the average in comparable countries. That comes out to an initial excess investment of $19.7 billion.
In the same vein, diagnostic thresholds have been lowered over time for conditions such as diabetes, hypertension, hyperlipidemia and osteoporosis in women, Crane noted. The result is additional “millions of people” diagnosed with chronic conditions, and many are likely to “not even be symptomatic.” Harm easily can arise from medical treatment delivered in the absence of symptoms.
“I believe this deadwood in our forest is due in large part to the incentives placed in our healthcare system [that] reward for treating symptoms and disease, rather than for maintaining and improving health,” he said.
Lifestyle choices. Tobacco use, poor nutrition, lack of physical activity and excessive use of alcohol contribute to the pervasiveness of chronic diseases, which affect 60% of Americans, according to the CDC. Two-thirds of that subset have multiple conditions, and hospital admissions are significantly higher for diabetes and heart failure in the U.S. than in comparable countries. The total cost of chronic conditions is $3.7 trillion, or 19.6% of GDP.
What’s more, by 2060, the number of Americans ages 65 and older is expected to double.
“This is a wildfire of biblical proportions that we can see coming,” Crane said.
He added, “The underbrush and deadwood are building in this forest as we continue to make lifestyle choices that are unhealthy. And then we seek care in high-cost settings.” With better choices, an estimated 30% of emergency department visits could be avoided, for annual savings of $2.5 billion.
Health inequity. Crane showed a slide with insights from the Kaiser Family Foundation, which found that mortality, morbidity, life expectancy, healthcare expenditures, health status and functional limitations are driven by social and economic inequities such as:
- Economic stability
- Neighborhood and physical environment
- Community, safety and social context
- The healthcare system
“We simply cannot achieve our highest level of cost-effective health without addressing this issue,” Crane said.
Crane said he is proud to be part of HFMA’s commitment to lead the industry in shifting its focus to optimizing the cost effectiveness of health.
“I challenge you to identify the underbrush and deadwood that are keeping your organizations and communities from being the healthy, thriving ecosystems they were meant to be,” he said. “And then I challenge you to take that next step: Ignite the spark setting the fire that brings about necessary change and innovation.”
Jackson hands off the baton
Crane was introduced to the audience Tuesday by Tammie Jackson, FHFMA, CPA, MHA, HFMA's FY21-22 National Chair, who was saluted during Tuesday’s session for her year as Chair and long record of service to the Association.
Reflecting on her Chair theme — “Bolder. Brighter. Better.” — and how it applied during a tumultuous year for the industry, Jackson said she’s been inspired by “just so many bold decisions that we've made, big and small, personal and institutional, to make things better for our industry, for our society, for our Association and for ourselves.”
Keynote speaker describes how to adopt a warrior spirit
In Tuesday’s keynote presentation, D.J. Vanas, an internationally acclaimed leadership and personal development speaker, explained how healthcare leaders can channel a warrior spirit as they navigate a turbulent period.
Vanas, an enrolled member of the Ottawa Tribe and a former U.S. Air Force officer, noted that the warrior role isn’t what people may assume from how it’s presented in popular culture.
From a traditional tribal perspective, to be a warrior means to be “somebody who has dedicated their lives to developing their Creator-given talent and ability so they could be an asset or a benefit to the tribe that they served.”