Simmons Celebrates Semi Annual Health Care Forum

November 21, 2017

Health Care Forum

Two Distinguished Experts offered reflections on accountable care and the future of healthcare delivery.

The Center for Research in Health Policy and Management at the Simmons School of Business presented a Healthcare Forum, The Challenge of Managing Accountable, Patient-Centered Care"on the management challenges of new forms of accountable, patient-centered care. This event, under the leadership of School of Business Professor Robert Coulam, brought a diverse audience to the school on November 9.

The event addressed the great challenge of managing outpatient health services amidst the current demands to produce accountable, patient-centered care. How do clinicians and practice managers deal with the conflicting pressures to improve cost and quality – at the same time? How well has this worked? What has been accomplished? What needs to be done now?

Two distinguished experts who have faced these problems from the front lines shared the challenges and promises of these major initiatives:

Health Care Forum - Lori Berry, MPH, MSW

  • Lori Berry, MPH, MSW, recently retired as CEO of the Lynn Community Health Center after more than 20 years. Under her leadership, the Health Center experienced significant growth, and now serves more than 40% of the residents of Lynn—over 40,000 patients. As CEO of the Center, Ms. Berry was a founding member of an innovative effort to develop an Accountable Care Organization for federally qualified health centers.

Health Care Forum - Stuart Pollack, MD

  • Stuart Pollack, MD, has served as Medical Director at Brigham and Women’s Advanced Primary Care Associates since its inception in 2011. The practice is a certified Patient-Centered Medical Home, a care delivery model whereby patient treatment is coordinated through primary care physicians with focus on coordination of care and patient engagement. It has received numerous national awards, including the Society of General Internal Medicine Quality and Practice Innovation Award.

The speakers emphasized the problems and discoveries in undertaking these new efforts:

  • Change fatigue – At a time of extensive changes in the health system, it is hard to have the resources and stamina to change the culture of practices and educate board members, providers, staff, and patients to deliver care a new way.
  • Resource demands – The need to hire new kinds of staff to accomplish such goals as care coordination requires new investments, which are difficult under payment methods from Medicaid and others that fail to cover many of the additional costs.
  • Imperfect incentives and serious risks – Providers are required to bear risk in the new arrangements, to create incentives for controlling cost and improving care. But the incentives are imperfectly structured, and the imposition of risk raises new and unfamiliar questions of how much risk a provider can manage – including the worry of whether chance enrollment of especially severe patients will overwhelm provider finances.
  • The importance of behavioral health – There has been a growing realization of how central behavioral/mental health care is in a patient-centered practice, especially for often indigent patients with complex health needs. This translates into a need for new staffing and different care processes to relate behavioral and medical care in new ways.

The underlying message of all these comments was sobering but hopeful. Long-standing cost and quality issues in the delivery of healthcare required new initiatives, and the direction of changes now being undertaken is promising. However, the changes are in far from finished form and will require extensive work and refinement actually to achieve their promise, with many risks along the way.

For those who missed the event, it is available on YouTube.

Photos courtesy of Lindsay Deal, '18LS