2020 will bring a shift in healthcare system

The focus of our healthcare system will shift away from ‘sickness’ to concentrate on ‘wellness’

Doctor talking to patient
Mark Mantei
MARK MANTEI The Vancouver Clinic

In Southwest Washington, we are fortunate to have high-quality and progressive healthcare. Most specialties and services are available on this side of the Columbia River and the talent pool of physicians, advanced care professionals, nurses, pharmacists and technicians is rich.

All of the major health systems adopt a cooperative stance in advancing the health of our population. We all connect patient care information through the same electronic medical record and are very progressive in terms of coordinating care, improving quality and holding down costs.

Healthcare is also a huge economic driver in our community. The major health systems – Vancouver Clinic, Legacy and PeaceHealth – are amongst the top 10 employers in Southwest Washington.

While the national picture on healthcare remains unpredictable, the local scene remains positive. Clark County continues to grow at a brisk pace (around 2% per year) and the population over age 65 is projected to grow at approximately 5% per year. As you know, we all consume more care as we age. This “Silver Tsunami” is driving demand for healthcare in our area that is unprecedented.

At Vancouver Clinic, we attracted 49 amazing new physicians and advanced care professionals (nurse practitioners, physician assistants and physical therapists) in 2019. We opened a new site in Ridgefield, which is already 50% above projections. We have another site opening in East Vancouver/Camas around Thanksgiving of 2020 and we expect to grow in 2020 at a pace very similar to 2019.

Healthcare can’t approach demand in the same way it has in the past. Healthcare represents nearly 20% of the American economy and more and more patients cannot afford the high costs.

The number one cause of bankruptcy in the United States is healthcare bills. Warren Buffett, the famous investor and billionaire, called the healthcare sector, “The hungry tape worm on the U.S. economy”. Clearly, we have to find ways to improve care while lowering costs.

Vancouver Clinic’s model emphasizes integrated care, prevention and evidenced-based strategies to address chronic illnesses like diabetes and congestive heart failure that drive the high cost of healthcare. We are working closely with employers, insurers and other members of the healthcare team to come up with strategies that improve our healthcare system.

Over the last several years, our leadership and its 350 providers have worked on ways to improve quality and address high costs. We’ve encouraged use of our urgent care over more expensive emergency room visits.

In 2020 and beyond, patients will continue to see improvements in quality, innovation and better value for the overall dollar. Complex procedures that once required overnight stays in the hospital are becoming more routinely performed in an outpatient setting.

Another great example of value and innovation is a unique partnership with Humana, a leading health and well-being company that offers Medicare Advantage and Dual-Eligible Special Needs plans.

As we age, we typically have more chronic and complex medical needs. That’s why, through a special neighborhood clinic located at Vancouver Plaza, that we teamed up on with Humana, we are working “upstream” to help Medicare and Dual-Eligible patients with both their medical needs and social determinants of health. In addition to physical exams and counseling to treat physical and behavioral needs, the clinic addresses social isolation, with areas for reading, puzzles, exercise classes, group activities and wellness presentations.

This team-based strategy is working and I think we will see more clinics like this in Clark County and across the country. In our first neighborhood clinic, we have shown that longer and more frequent visits with a primary care clinician reduces hospitalizations and ER visits by over 50%.

One saved visit to the ER pays for approximately 10 office visits with a doctor who knows the patient. One avoided hospital stay can pay for homebound care for close to a year.

As we enter a new decade, I expect the focus of our healthcare system to finally shift away from a “sickness” system to one that concentrates more on “wellness.” We will see technology advancements in places that will help our health teams monitor and react to changes in a patient’s health that will keep them enjoying a healthy lifestyle longer.

We will also see amazing advances in surgical interventions like total joint surgery that won’t require a hospital stay. It’s going to be an exciting time, regardless of the shifting political winds in the other Washington.

Mark Mantei brings more than 30 years of public health experience to Vancouver Clinic as their Chief Executive Officer. He serves on the Board and Executive Committee of America’s Physician Groups. He can be contacted at mmantei@tvc.org.