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Monday, Jun 18, 2018
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Charles Lockwood: A medical transformation in the Tampa Bay region

Health care in America is experiencing extraordinary stress, and Tampa Bay area residents clearly have their share of concerns about the costs and quality of their care.

At USF Health, our faculty in public health, pharmacy, nursing, physical therapy and medicine are daily analyzing health care concerns confronting our communities, and we are formulating plans, policies and programs to help our patients receive the best and most affordable care possible.

The source of America’s health care crisis is the unsustainable rise in cost. It has been projected that by 2018, health care expenditures will consume 20 percent of the U.S. gross national domestic product.

Even now, health care costs are one of the largest contributors to our federal deficit, and large and small businesses understand that the cost of employer-based health coverage is eroding their economic competitiveness. For example, Starbucks pays more for employee health care than for coffee, while General Motors pays more for health care coverage than for steel. Yet while the United States has the highest health care costs in the world, it ranks only 37th (according to the World Health Organization) in health outcomes.

Here in the Tampa Bay area, our health care systems also are burdened by a rising population, which in the next five years is expected to increase 6 percent overall, and 17 percent amongst those over the age of 65, the highest consumers of care. Conversely, compared to the rest of the nation, the Tampa Bay region has a relative deficiency of both specialist and primary care physicians. Our nursing shortage is even more dire. Although we at USF Health are responding to this provider shortage by raising student enrollments and encouraging graduates to remain in the region, it is clear that significant physician and nursing shortages loom large.

We simply cannot afford the cost of our current expensive, fragmented and dysfunctional health system. Providers must transition from being paid for services rendered to being paid for the actual quality of care provided.

We at USF Health are facing these challenges head on, and with a great deal of ingenuity. Beyond optimizing our current health system’s scale and operational efficiency, in the next few years we will join with high-quality partners to create robust and clinically integrated health care networks (CINs) that will balance optimal care for patient populations while keeping costs affordable. We are convinced that more and more primary and specialty care physicians will join these networks, and that consumers will increasingly receive care at all stages of life from networked health care organizations.

These evolving CIN systems will need to emphasize highly efficient single-disease treatment practices that maximize patient satisfaction, safety and outcomes at lower costs by harnessing teams of highly specialized providers and facilities, and novel information technologies.

These will enable us to make earlier diagnoses, provide genetic-based personalized therapy and optimize patient adherence with care. Simultaneously, we are partnering with others in ways that will optimize access to primary preventative care, all helping to avoid disease in the first place.

Increasingly, the focus of care will shift from hospitals to outpatient settings and from doctors’ offices to the home and community.

Similarly, we will soon transition from current, costly fee-for-service payments, which encourage excessive treatment, to value-based payments where providers are reimbursed for achieving better patient outcomes for lower overall costs. Both patient outcomes and the costs of care will be transparently published to allow consumers to choose among different CINs based on value.

As the only academic health center on Florida’s west coast, USF Health has an obligation to take a leadership role in this transformation, which promises to not only make us healthier but drive economic development by reducing the cost of doing business.

So we will work closely with a growing number of partners and competitors to foster excellence, increase the quality of care and optimize health outcomes while keeping costs as low as possible.

At a time when the costs of health care are too high and the number of patients are growing rapidly, coordinating and cooperating across integrated and highly efficient health care teams is the best way to move forward.

Charles Lockwood, MD, is senior vice president of USF Health and dean of the USF Health Morsani College of Medicine.

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