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Transformation Meets Resistance

By Dr. David C. Pate, News and Community
August 27, 2012

Note: The Idaho Statesman published the following as my Reader's View guest column in the Aug. 26 edition of the newspaper under the headline, "St. Luke’s is motivated to keep health care costs down."

St. Luke’s has set out to transform health care. We are trying to find ways to make investments in promoting health, keeping people healthy, and lowering health costs for Idahoans in all the regions we serve.

It’s harder than you’d think. And we have to do it. 

St. Luke’s is working on reducing hospital costs in a number of ways, including implementing best practices and lean methodologies used successfully in other settings.

But we know we will not save enough to make up for the cost of new patients with more disease, the consequence of the effects of the childhood obesity epidemic, to prevent continuing escalating health care costs.

The most effective way to lower costs is to keep people healthy. St. Luke’s is working with various insurance companies, employers, Medicaid, and Medicare  to develop creative ways to reduce the total costs of health care by improving health, providing better care, and using innovative new models of care and insurance.   

One example of this effort is a collaborative program with Regence BlueShield of Idaho that we announced Wednesday that is directed at improving care coordination, thus reducing health care costs.

We believe other substantial investments also will pay off as lower health care costs and more affordable insurance for Idahoans. For example, we have developed a spine wellness center to try to reduce the number of expensive back surgeries. That’s better for patients, but it means a loss of income to our hospitals. 

St. Luke’s is investing millions of dollars in an electronic medical record system that connects patient care with all the treating physicians in our health care system. Patients can now view their medical records online, check on test results, and email their physicians. And we have piloted a wellness initiative among St. Luke’s employees that has demonstrated tremendous success at reducing smoking, blood pressure, and blood sugar. It’s a program we now can use to help our communities be healthier.   

We can’t innovate without physicians who share this vision of transformation. We are providing the tools and teams of health care professionals for these physicians to develop shared best practices for improving the health and care of Idahoans throughout the region we serve. This is one reason St. Luke’s has been growing. So, for example, physicians in rural areas are able to provide coordinated care locally with the availability of advanced care services and specialties in Twin Falls and Boise/Meridian when needed. 

Transformation in a high-stakes, high-risk arena such as health care is complicated, costly, and frightening to many people. We’re hearing from some of those people now. People don’t like change. And in some instances, St. Luke’s success would mean lower health care costs at some expense to various interests.

But we can’t afford not to do it.

I have had many conversations with our board members and leadership team about the consequences of our journey of transformation. We know not to be surprised by complaints and misrepresentations of our actions and decisions as we do our part regionally to shift what we all know is a broken national health care delivery system.

We remain undeterred, because fixing it is the right thing to do. Our boards, physicians, and leaders are committed to transforming health care. As I’ve said, it’s not easy; few things that are meaningful and important are. St. Luke’s is dedicated to providing better health, better care, and lower costs. It is our communities that will benefit.

About The Author

David C. Pate, M.D., J.D., is president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.