Prevention has always proven successful. Healthcare systems, foundations, healthcare support businesses, and philanthropic partners have supported efforts to help people, communities, and even entire states embrace wellness and become healthier. During a recent thoughtful conversation between senior leaders of a group engaged in prevention and thought leaders from an iconic national healthcare organization, the following question surfaced:
“Why don’t all communities and organizations embrace effective prevention?”
The answer, though complex, is certainly not due to a lack of altruism, competence, or concern; rather the focus is on healing the sick, illness by illness.
The current viewpoint makes imagining a different future difficult. “It has always been this way,” or “We are just too busy caring for our current stressors to take on anything else right now,” are two understandable human reactions.
Fortunately, better options are available; regrettably, they do require an initial expenditure of time, energy, and capital. The investment long term reaps huge rewards for individuals across the socio-economic spectrum and communities from desolate rural to dense urban.
Two major forces continue to slow progress to a comprehensive successful long-term solution:
- Hospitals, healthcare systems, physicians, and care-providers have been focused and trained on diagnosing and treating disease. And we are the best in the world—if you are sick, you want to be cared for in America.
- Fee-for-service, the traditional payment system, has not rewarded prevention. Yet now, pay-for-value and any form of capitation (Medicare Advantage, managed Medicaid, etc.) are growing and will benefit systems (including insurance companies) caring for or insuring healthier populations.
Well-meaning, altruistic, resource-intense, and focused, but not necessarily comprehensive or viable, platforms are also being adapted. In general, these programs do not have robust metrics or built-in plans for sustainability.
- Some of the large philanthropic healthcare systems are developing their own, mostly focused, prevention programs individually addressing housing, food deserts, violence, and other societal maladies.
- Other groups of altruistic healthcare organizations admirably fund local projects. However, long-term duration of this charity is a realistic concern, particularly with profit margin squeeze caused by decreased reimbursement and increased expenses.
The positive energy and commendable image created by the above two endeavors do give a short-term “high.” But without long-term objective measurable outcomes, these programs will sadly wither away, much as previous projects lost their luster and became an unexpected tax on the sponsoring institution.
Now is the time to embrace methods with objective metrics. Healthcare systems’ core competency is caring for sick patients. Branching into prevention is a new and necessary venture best assisted by experts with proven processes, resulting in measurable outcomes.