Engaging patients in health care urged

A model for getting and providing health-care services that assigns every person a medical home where prevention is the focus and patients actively participate in staying well received a hearty endorsement from a special panel of state lawmakers Thursday.

Members of the Legislature's Health System Reform Task Force couldn't find much wrong with the notion of assigning everyone a "medical home" that would in effect make the primary care physician the access point for everything from preventive screenings for diseases to specialized procedures.

Key to making the model work isn't just the way care is delivered or whether the 300,000 Utahns without insurance get covered, but the actions of every individual to get and stay healthy, lawmakers were told.

"We're basically getting what we pay for," said Rep. Brad Daw, R-Orem and a task force member. "Right now we're paying for a lot of care because we won't change our diet or other habits. People generally don't believe they can have much control over their health, and making them accountable for that isn't necessarily something people want."

Instead of more dire predictions of what can't be done to get health-care costs under control, lawmakers left their monthly meeting wondering why prevention and patient-based models being implemented by a few hospitals and care providers couldn't be expanded statewide. An economic disaster on par with the financial meltdown now under way on Wall Street is in the offing if the way things are done continues: Without a massive overhaul of the health care industry, top to bottom, from private, employer-based health plans to the price and quality of care provided, the amount of money spent annually per Utah household will equal the average household income in less than 10 years.

People could be given real incentives for progress they make, said Michael Magill, chairman of the Department of Family and Preventive Medicine at the University of Utah School of Medicine and founder of a coalition of providers investigating ways to increase quality and value of health-care services.

"The vehicle to change the delivery of health care is a market-driven initiative that promotes a continuing, one-on-one relationship with a primary care physician who can provide a continuum of care, possible health risks in collaboration with patients who are actively involved in staying well," he said. Robert Wheeler, a primary care physician and medical director for Regence BlueCross BlueShield of Utah, said medical homes are an example of how the system must undergo a fundamental transformation, not a reformation.

"There's been all kinds of interest in how to enhance the market of health care," he said. "The money goes for services rendered. There is gobs of information on the number and types of care that is purchased within the system. But there is a big disconnect on what happens to patients after the service has been provided."

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