HealthePeople Strategy

Vision

Today in America, we are spending 1/6^th (about $2.5 trillion) of our national economy on health without producing healthy Americans or a healthy America. Without a quantum change in health vision, strategy and execution, our future will be as disappointing as our past.

To positively change that future, “Building a Healthy America” is a proposed national strategy, using “HealthePeople” as a supporting strategy, whose near-term vision is to achieve substantially healthier Americans and a substantially healthier America. The long-term vision is to achieve healthy Americans and a healthy America.

This “Building a Healthy America” strategy was created with the belief that America can reach this vision via an endgame strategy of a high performance, American health and long term care system for all Americans that is self-perpetuating, affordable, accessible, “e” enabled, and producing high health quality, outcomes and status.

Such an American system, partly physical and partly virtual and put into place by collaborative private and public partnerships, will greatly improve accessibility, quality and affordability for all Americans. Such an American system can greatly improve health and help achieve a healthy America.

Rationale for HealthePeople

There is and should be little disagreement over the need for America to have a substantially better health system. None of the key indicators – health status, accessibility, quality, affordability – are at acceptable levels for a nation spending 1/6^th of its economy on health.

Accessibility – Over 47 million Americans are uninsured for health care and millions more are underinsured. Most Americans are uninsured or underinsured for long term care. Needed health and long term care services are insufficiently available and/or accessible to many inner city and rural communities. A collaborative partnership of people, public and private payers, and health care organizations can substantially improve access for all Americans.
Quality – Health status and outcomes produced by the American health “system” are inadequate given the needs of the American people and the 1/6th of the national economy expended. Too little of our medical and health knowledge is being effectively applied to prevent and treat health problems and to ensure health care is safe. A collaborative partnership of health care organizations and the people they serve can substantially improve health care quality and health outcomes for all Americans.
Affordability – The unaffordability of health care is challenging America as a nation (1/6^th of the national economy and growing) and Americans as individuals and families (inhibiting needed access and causing bankruptcies). These problems continue to grow. A collaborative partnership (health care organizations, the people they serve, and the people and organizations who pay) can much more effectively use America’s valuable health resources.

We, as a nation, are spending enough money. We are just not getting the requisite payoff in terms of health outcomes/status or satisfaction.

Vision, Endgame Strategy and Mission

The “Building a Healthy America” near-term vision – achieve substantially healthier Americans and a substantially healthier America - is far different than the one we can expect from our current glidepath. Much more so is the long-term vision - achieve healthy Americans and a healthy America. All current indicators and trends point to a future where access, quality and affordability continue to be unacceptable. Under a better vision and strategy with the same resource commitment, America can achieve substantially healthier Americans and a substantially healthier America.

To reach this vision, the endgame strategy is to achieve a high performance, American health and long term care system for all Americans that is self-perpetuating, affordable, accessible, “e” enabled, and producing high health quality, outcomes and status. An American health system should bring together and to bear the full force of people and their clinicians, their healthcare providers, their healthcare payers, their communities and their governments.

To reach this vision and endgame strategy, the mission is to create and support collaborative partnerships that help build a high performance, American health and long term care system for all Americans that is self-perpetuating, affordable, accessible, “e” enabled, and producing high health quality, outcomes and status. This unprecedented collaboration can achieve great progress as we have seen America achieve historically on other national issues. “Building a Healthy America” achieves full success when an American health system achieves and sustains healthy Americans and a healthy America.

Strategy for a Healthy America

“Building a Healthy America” is a collaborative strategy to transform to affordable, person-centered, outcomes-driven, and "e" enabled health systems that help achieve better health. Succeeding with this strategy across all healthcare will positively transform health care. We can use our nation’s valuable health resources much more effectively, reduce vulnerability, and achieve much healthier Americans and a much healthier America. Within this strategy are two core elements:

First, achieve affordable, accessible, and high quality/performance health systems. This involves more than medical interventions or traditional healthcare services. It requires a full range of health-related resources from across the community and beyond.
Second, focus on people—consumers, patients, enrollees, and members. They are the center of the health universe and must be treated as such, forming strong partnerships between individual persons/patients and their healthcare providers.

Under the “Building a Healthy America” vision and overall strategy and using “HealthePeople” supportive strategies and models, we can positively transform the overall American health system and achieve a healthier America requires by successfully applying the following 15 supportive strategies:

Create a supportive environment for high performance, quality, affordability, accessibility
Support strong person-centered health with high personal choice, self care and a strong partnership between the person and their health professional/provider to improve resource use and health outcomes
Support strongly and collaboratively applying “public health” model
Support all needed care reasonably accessible financially
Support the most vulnerable persons being provided all needed health and long term care (LTC) support
Support strong core health benefits
Support strong core LTC benefits
Support strong person-centered care coordination/management
Support effectively using prevention to avoid illness and disability and associated cost
Help ensure long term affordability
Support pay for effective care & effective resource use
Support aligned high performance measures for all/across care settings
Support strong quality/performance improvement for all/across care settings
Support all care settings being reasonably accessible physically
Support strong virtual health (info) system with EHRs, PHS/Rs, standards & interoperability/exchange.

While all 15 supportive strategies are essential, there are several strategies that have unique potential and deserve elaboration and greater attention:

Person-Centered Health - where the person a) is at the center of self care, formal health care and informal health support and b) has that health care/support coordinated via an effective person and clinician partnership.
High Performance Health Systems - where the best systems design and operational thinking is applied to and across the full range of health care settings from individual clinics to hospitals to integrated health systems.
Care in the Community – where care coordination and eHealth are utilized as means to better support people’s health outside (“in the community”) and with health care facilities in real time at any time and anywhere.
Quality/Health Improvement - where we build upon IOM work on quality, better use evidence-based care, and develop and use behavioral models for person and clinician behavior to improve health care quality and health outcomes and status. One key focus is “right care for every person every time.” Another key focus to more effectively use prevention and early intervention to avoid illness and disability.
Un- and Underinsured - where we build upon IOM work on uninsured and develop and execute strategies that solve the un- and under-insured problem in way supportable by key leaders and American public.
Virtual Health Systems - where we develop and use “virtual health system(s)” of electronic health records (EHR), personal health systems/records (PHS/R), information exchange (IE) and standards. Though “virtual health systems” are only part of the answer, creating an American health system requires the enabling “e”.

Building a Healthy America Vision and Strategy

As a nation, we should proceed under the belief that America can reach this vision via an endgame strategy of a high performance, American health and long term care system for all Americans that is self-perpetuating, affordable, accessible, “e” enabled, and producing high health quality, outcomes and status. Such an American system, partly physical and partly virtual and put into place by collaborative private and public partnerships, will greatly improve accessibility, quality and affordability for all Americans.

Utilizing “Building a Healthy America” as an organizing strategy, we can build a substantially healthier America and move toward a truly healthy America. Americans deserve and should expect nothing less.

Building a Healthy America and HealthePeople Strategy

[Link to Full Paper]