HealthePeople - Vision and Strategy for Achieving Healthy People and Building a Healthy and Thriving Future

HealthePeople - Strategy Paper

Vision, Endgame Strategy and Mission

The “HealthePeople” near-term vision – achieve substantially healthier Americans and people globally and a substantially healthier America and world - is far different than the one we can expect from our current glidepath. Much more so is the long-term vision - achieve healthy people globally and a healthy, thriving world. All current indicators and trends point to a future where access, quality, affordability and health status continue to be unacceptable. Under a better vision and strategy with the same resource commitment or America and a greater resource commitment for nations in great need, we can achieve healthy people globally and a healthy, thriving world.

To reach this vision, the endgame strategy is to achieve high performance, health (including long term care) systems for all people that are self-perpetuating, affordable, accessible, “e” enabled, person-centered, and producing high health quality, outcomes and status. A 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 high performance, health and long term care systems for all people that are self-perpetuating, affordable, accessible, “e” enabled, person-centered, prevention-oriented, and producing high health quality, outcomes and status. This unprecedented collaboration can achieve great progress as we have seen America and other nations achieve historically on other national issues. “HealthePeople” achieves full success when health systems globally achieve and sustains healthy people globally and a healthy, thriving world.

Strategy for Healthy People and a Healthy and Thriving World

“HealthePeople” is a collaborative strategy to transform to affordable, person-centered, prevention-oriented, 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 valuable health resources much more effectively, reduce vulnerability, and achieve much healthier Americans and people globally and much healthier America and world. 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 “HealthePeople vision and overall strategy, we can positively transform health systems and achieve a healthier America and world by successfully applying the following 15 supportive strategies:

1. Create a supportive environment for high performance, quality, affordability, accessibility
2. 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
3. Support strongly and collaboratively applying “public health” model
4. Support all needed care reasonably accessible financially
5. Support the most vulnerable persons being provided all needed health and long term care (LTC) support
6. Support strong core health benefits
7. Support strong core LTC benefits
8. Support strong person-centered care coordination/management
9. Support effectively using prevention to avoid illness and disability and associated cost
10. Help ensure long term affordability
11. Support pay for effective care & effective resource use
12. Support aligned high performance measures for all/across care settings
13. Support strong quality/performance improvement for all/across care settings
14. Support all care settings being reasonably accessible physically
15. Support strong virtual health (info) system with EHRs, PHS/Rs, standards & interoperability/exchange.

HealthePeople Model

Vision

Today in America, we are spending over 1/6th (nearly $3 trillion) of our national economy on health without achieving healthy people or a healthy America. Most of the rest of the world faces major challenges in achieving healthy people and healthy nations. Without a quantum change in health vision, strategy and execution, our future will be as disappointing as our past.

To positively change that future, “HealthePeople - Building a Healthy and Thriving Future” is a proposed strategy whose near-term vision is to achieve substantially healthier Americans and a substantially healthier America and to achieve substantially healthier people and substantially healthier nations. The long-term vision is to achieve healthy people globally and a healthy, thriving world.

This “HealthePeople - Building a Healthy and Thriving Future” strategy was created with the belief that we can reach this vision via an endgame strategy of high performance, health (including long term care) systems for all that are self-perpetuating, affordable, accessible, “e” enabled, person-centered, prevention-oriented, and producing high health quality, outcomes and status.

Such systems, partly physical and partly virtual and put into place by collaborative private and public partnerships, will greatly improve accessibility, quality and affordability for all people. Such systems can greatly improve health and help achieve healthy people and a healthy, thriving world.

Rationale for HealthePeople

There is and should be little disagreement over the need for substantially better health systems. Using America as example, none of the key indicators – health status, accessibility, quality, affordability – are at acceptable levels for a nation spending 1/6th of its economy on health.

Accessibility –Even with the 2010 health reform, million of Americans are uninsured for health care and millions more are underinsured. Most Americans are uninsured or underinsured for long term care. Needed health (including long term care) services are insufficiently available and/or accessible to many inner city and rural communities. Here in America and globally, a collaborative partnership of people, public and private payers, and health care organizations can substantially improve access for all people.

Quality – Health status and outcomes produced by current health systems are inadequate given the needs of people in America or globally and given that America expends 1/6th of the national economy on health care. The 2010 health reform in America makes some but far too little progress. In America and globally, too little of our medical and health knowledge is being effectively applied to prevent and treat health problems, to ensure health care is safe and to achieve high health status. A collaborative partnership of health care organizations and the people they serve can substantially improve health care quality, health outcomes and health status for all people.  Achieving a healthy people.

Affordability – The unaffordability of health care is particularly challenging in America (expending 1/6th of the national economy and growing) and Americans as individuals and families (inhibiting needed access and causing bankruptcies).  Similar issues of affordability face other nations as well. The 2010 American health reform makes some progress on affordability by improving insurance access but makes relatively little progress on improving affordability overall. Without further action, these problems will continue to grow. The same is true for other nations.  A collaborative partnership (health care organizations, the people they serve, and the people and organizations who pay) can much more effectively use valuable health resources. America is spending enough money.  Other nations vary widely on the relationship between spending and need. Globally, we are just not getting the requisite payoff in terms of health outcomes/status or satisfaction.

High Performance Health System

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 the Institute of Medicine (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 the 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 effective health systems requires the enabling “e”.

HealthePeople - Achieving Healthy People and Building a Healthy and Thriving Future

As a nation and world, we should proceed under the belief that we can reach this vision via an endgame strategy of high performance, health and long term care systems for all people and nations that are self-perpetuating, affordable, accessible, “e” enabled, person-centered, prevention-oriented, and producing high health quality, outcomes and status. Such health systems, 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 and all people globally.

Utilizing “HealthePeople” as an organizing strategy, we can build a substantially healthier America and world and move toward a truly healthy, thriving America and world. People deserve and should expect nothing less. Utilizing “HealthePeople” as an organizing strategy within America and globally, "HealthePeople" takes the critical next step to help achieve healthy people and build a healthy and thriving future for America, for other nations and globally.