If A Health Plan Could Be A Person……………..

Dave Chase

In this era where healthcare has been politicized (a great way to freeze status quo), I’m happy to report that Health Rosetta’s core tenets draw agreement from both ends of the political spectrum. They spell out HEALTH.

By Dave Chase

If a health plan could be a person, you’d want it to be a great parent. Mom/dad do their best to keep you healthy and out of harm’s way. When you have a “great” idea that may not be well-advised, they steer you away from danger. When you are sick, they help you get back to full health as quickly as possible. Does that sound like a status quo plan? Not in my experience.

In this era where healthcare has been politicized (a great way to freeze status quo), I’m happy to report that Health Rosetta’s core tenets draw agreement from both ends of the political spectrum. They spell out HEALTH.

  • Health professionals are incredibly compassionate people who are well trained and want to do good.
  • E-Patients are smart but frustrated they can’t be healthier — because our modern society is in many ways stacked against their health.
  • Avoiding waste means at least $1 trillion can be reinvested in proven outcomes that actually drive health.
  • Local: Health starts at home.
  • Trust is built through transparency and openness.
  • Human-centered health plans restore health, hope and well-being.

Each of these tenets are expanded upon in this chapter (PDF). We define “community” in the broadest sense where a community can be an employer, union or ultimately a placed-based community. We are seeing that community fractals, such as employers, can be knitted together. Rather than the old way model of an employer having a renter mindset of “renting” a sick care plan controlled by profit-centric carriers, they have an ownership mindset.

Employers collaborate with others to share common approaches to primary care and procurement of hospital services or drugs. These employers may also cooperate on shared risk pools for outlier claims as well as wise approaches to outlier claims. As the chapter outlines, misdiagnosis rates range from 20% in cancer to 67% on spinal surgeries. In the book’s preface, I outlined the devastating impact of incorrect diagnoses that are uncommon in true Centers of Excellence — literally lives depend on getting people to the most appropriate site of care. Some studies suggest that the third leading cause of death in the U.S. are preventable medical mistakes. Typical, old-line health plans have provider networks that are little more than glorified yellow pages and put individuals in harm’s way. Smart health plan design can almost always avoid those kinds of mistakes.

Key chapter take-aways

  • Health starts at home. The best health plans are those that are rooted in the community and that serve the community, mitigating social determinants of health, improving outcomes, and freeing up previously squandered health care dollars.
  • Investing in local primary care practices/physicians is critical. There is no high-function health care system in the world not built on it, and U.S. primary care must be rebuilt from the ground up.
  • Leaders should look at their health plan from a parent perspective, as health, public safety, education, and other issues are inherently linked. By improving one, leaders can improve others.
  • Wellness programs are optional, and money is better spent on what truly drives health and well-being, such as value-based primary care.
  • There are extraordinary rates of misdiagnosis and overtreatment that put patients in harm’s way. The savings from avoiding complications, misdiagnosis, and overtreatment more than pay for the extra cost of travel (if required) to world-class centers.
  • The highest quality centers have a team-based model that allows for more accurate diagnoses and more appropriate treatment plans.

About Health Rosetta

At Health Rosetta we empower community-owned health plans: high quality, trustworthy, local, affordable care — that you thought had disappeared forever — from caregivers we know and trust. We free up compassionate, well-trained, community-based caregivers to rediscover love in medicine so they can do what they have always been called to do: serve their patients not just in disease, but toward their fullest health. A trusted and sacred caregiver-patient bond is built through transparency and openness that equips and empowers patients wherever they can best achieve their unique health goals — at home or any setting best optimizing their health and well-being. By avoiding the 50% wasted healthcare spending, we can ensure our caregivers have the independence and resources to address the psychosocial and medical issues their patients face in human-centered health plans that restore health, hope and well-being in our communities.

Health Rosetta
3019 NE 127th St, #27-633
Seattle, WA 98125

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