Featured in the May/June 2013 Colorado Medicine.
Alfred Gilchrist, Chief Executive Officer
Colorado Medical Society
As this issue of Colorado Medicine goes to press, Governor John Hickenlooper will be rolling out a plan that proposes to make Colorado the healthiest state in the nation. While far too many states are wrapped around the axle of partisan and ideological bickering over health care costs and entitlements, our governor has developed a plan that elevates and accelerates an already solid base of collaboration inspired by the bipartisan 208 Commission. (Preceding the Affordable Care Act by several years, the 208 Commission established a homegrown consensus framework for health care reform in 2008.)
The governor’s plan also represents a paradigm shift that physicians and other health care advocates have long argued: the role of government in health care is that of an investor and collaborator, to support an investment infrastructure no less critical to economic health and growth than the same investments the state makes in public and higher education, highways water, and energy. The report makes these obvious and compelling connections over and over: “Healthier Coloradoans mean a more productive workforce, which in turn, supports economic growth, attracting businesses and skilled labor to Colorado. An improved economic outlook means additional resources and improved social and environmental conditions.”
The plan also formalizes the common sense notion that public health is fundamental to better health: “Research increasingly shows that health care is actually only a small component – about 10 percent – of what shapes the health of individuals. The remainder is due to genetics, individuals’ behaviors and lifestyles, and the environmental and social conditions where people live, learn, work, and play. “
The working models of collaboration and community-centric care delivery have been evolving in Colorado since the earliest efforts that established Rocky Mountain Health Plans in Grand Junction more than 30 years ago. The current private sector care coordination projects featuring medical homes and neighborhoods, the early positive results of the Medicaid Regional Care Collaborative program, the patient engagement work of Patti Skolnik, and the many other innovative experiments now maturing into full-on systems continue the trend.
The initiatives in the governor’s plan are daunting but self-evident: tackle obesity; improve mental health and reductions in substance abuse; improve oral health; expand public and private health insurance coverage; close gaps in access to primary care; encourage employee wellness; expand patient centered medical homes; support access to state information and services; improve access to community-based long term care; cost containment in Medicaid over the next 10 years (which care coordination can achieve); and invest in health information technologies.
At a time of great uncertainty, we are fortunate to have a large reservoir of leaders in the public and private sectors coming together to fix problems, not blame. These are more than platitudes and noble ideas. The plan is grounded in the practical aspects of what works, and what could work through an inclusive approach – a very healthy start to this righteous mission.