Making healthcare more affordable for the people it serves is a top priority for Intermountain Healthcare.
That's what Intermountain CEO Marc Harrison, MD, said at meetings held this summer with managers from across the Salt Lake City-based health system. Harrison told managers that Intermountain is well-positioned to lead the nation in providing the best care at an affordable cost, and, with the help of each caregiver, it's a goal that can be achieved.
"We have a crisis in American healthcare right now," Dr. Harrison said. "Healthcare is unaffordable. The existing healthcare system is oriented toward driving volume. As an industry we do too many things to too many people that they really don't need, which hurts them economically, and sometimes physically. But Intermountain has a great history of innovation and together we can drive change."
Dr. Harrison shared some alarming national statistics about the cost of healthcare:
- One in four people will forego medical care this year because it's too expensive.
- One in three Americans ration their prescription drugs because they can't afford them.
- About half of Americans worry an unexpected healthcare expense will bankrupt them.
- Healthcare expenses are the number one cause of bankruptcy in the United States
Dr. Harrison says the statistics are better in Utah and Intermountain's charity care program is helping those who can't afford care, but he says more needs to be done. Last year, Intermountain provided more than $246 million in charity care to patients in need of financial assistance.
"We're doing a great job with the cost of healthcare and Intermountain is as competitive and cost-effective as any large system in the United States," he said. "But we have a long way to go and we're going to drive this forward together. How are we going to get there? By keeping people well, by providing the most accessible and affordable care, and by creating a sustainable model."
Examples of innovative solutions at Intermountain that are reducing costs and improving care, which Dr. Harrison shared with managers:
- Civica Rx, the not-for-profit generic drug company banded together by Intermountain and other healthcare systems and philanthropists to fight the skyrocketing cost of prescription drugs by providing low-cost generic drugs to participating hospitals.
- Reimagined Primary Care, the team-based care model that focuses on preventive care to keep patients well. The model already has about 25,000 patient members enrolled and has seen impressive results, such as a 60 percent decrease in hospital admissions, 35 percent decrease in emergency department admissions, and a 20 percent decrease in per member per month costs.
- Addressing social determinants of health such as stable housing, food, transportation, and employment.
- Reducing opioid misuse. Intermountain has reduced the number of opioid tablets prescribed for acute care by more than 30 percent in the last year and is working hard to make further reductions.
- Integrating mental health care into clinics as part of each patient's primary care experience.
- Finding and implementing caregiver ideas. Intermountain caregivers implemented nearly 49,000 continuous improvement ideas in 2018 — more than 130 ideas each day. Many of these ideas both improved quality and reduced expenses.
"We didn't do these things for our self-aggrandizement," Dr. Harrison said. "We did them for our neighbors. And we're in just the right position to continue to be an innovator."
Dr. Harrison added that although helping people stay well and out of the hospital is a key part of Intermountain's strategy moving forward, that doesn't mean we won't continue to provide the best possible hospital care when our patients need it.
"We'll still focus on helping people when they're in a car accident, have a heart attack, or get cancer," he added. "But we have the opportunity to do that in conjunction with a 'keep people well' system. We're still going to have great trauma programs, great heart surgery programs, great cancer care programs, and great neuro ICUs, but won't it be terrific if we can actually keep people out of some of those places? And have them stay as close to home as possible in the least restrictive environment?"
Dr. Harrison emphasized that Intermountain is making changes from a position of strength.
"Intermountain, in a really tough environment, is really doing well. Our quality and safety have never been better. Our patient experience is on the rise. At a time when a lot of other health systems are struggling economically, we're strong. But we need to continually innovate and change to remain a model healthcare system. If not us, who? If not now, when?"
Other things Intermountain and SelectHealth (Intermountain’s insurance arm) are doing to reduce costs and return money to its patients and members:
- Lower annual rate increases. Intermountain reduced annual price increases in 2019 by $15 million.
- Lower-cost care settings. Intermountain is reducing unnecessary ER visits by increasing access to appropriate care in lower-cost settings such as InstaCares (urgent care clinics), physician offices, and Connect Care virtual visits.
- Lower individual premiums. SelectHealth reduced individual plan premiums by an average of 2.7 percent in 2019.
- Affordable SelectHealth Share premiums. Intermountain guarantees a premium rate increase for new clients of SelectHealth Share of only 2.5 percent in years two and three of their three-year contract. For current clients, the guaranteed premium rate increase is only 2 percent for all three years. This compares to an industry-wide premium increase of more than 5 percent.
- Stork Savers. Intermountain's Stork Savers program offers a lower-cost cash price to patients without health insurance for mom and baby care associated with uncomplicated births.
- Supply initiatives. Intermountain has a set ratio between what it pays and what it charges patients for supplies and drugs. When Intermountain reduces its costs, it can directly lower charges to patients for those items. Intermountain negotiated better prices on supplies in 2018 that resulted in more than $32 million in cost savings.
- Financial assistance. Intermountain expanded its financial assistance program to cover needed health services for families with income levels up to 200 percent of the national poverty level. The 2019 national poverty level for a family of four is $25,750.