Earlier this summer, Yair and I made our way to a library fundraiser in Lake Tahoe. There was a stack of free magazines in the corner and I grabbed a few of them for casual reading. After a couple of months of the stack sitting in our closet, I just picked up the August 2010 issue of U.S. News (“Patient Survival Guide”), and it had a lot of really interesting articles on social innovation and policy change in healthcare.
Two articles popped out at me:
1. Montefiore Medical Center in the Bronx (just a few miles away from where Yair and I lived) has transformed the way that it handles patient care. The center serves a very poor population with roughly 1/3 of its patients below the poverty line. The hospital’s medical expenses were sky high. Montefiore established their own HMO where employers pay a flat annual fee and a sizable portion of the community (~200,000 people) have been enrolled. They also have 80% of their doctors on salary instead of a commission structure, reducing the incentive to order unnecessary tests and seem to still be a top medical facility with significantly lower costs, according to the article. The Montefiore network is also an attempt to change the current fragmented system where a patient’s internist, cardiologist and hospital doctor may not be communicating effectively or have no interaction at all. Perhaps more interestingly, Montefiore has a team of doctors dedicated to doing home visits to check in on high-risk and older patients and monitor their health, reducing the hospital re-entry rate of these patients. (The costs of the visits are fully covered by Medicare.)
2. On a lighter note, there is a small town called Albert Lea in Minnesota that is pioneering the Blue Zones Vitality Project. The community received a grant and committed to making healthy lifestyle changes for their residents over the past year. This effort included bringing in consultants to encourage local restaurants to offer half-size entrees, salads instead of french fries and so forth. More interestingly, the community’s “school bus” is now a dedicated walking group with meeting points throughout the town and a couple of volunteer parents as chaperones. Instead of spending money on school buses and gasoline, students are starting and ending their day with outdoor exercise while being environmentally friendly at the same time. Perhaps the most fun part of this story is that – since social interaction is a key element to mental and emotional health – the town sponsored seventeen block parties and forty-six community garden plots to get residents out of their houses and interacting with friends and neighbors. Albert Lea residents reported feeling happier, healthier and having significantly lowered their BMI during the trial. While their pioneer year and grant funding has ended, many of the initiatives will likely continue and the next Blue Zones Vitality town will soon be announced for a three-year trial period.
Maybe Yair and I should move to the soon-to-be-announced town and join the project’s pioneering group… that is, warm-weather permitting.
posted by ayo