Welcome to YHC and Preventive Healthcare

The purpose of this blog is to share knowledge and experience content for individuals interested in the prevention and management of wound care related issues. Experts will discuss important topics in the field which will hopefully improve overall breadth of knowledge and lead to overall improvement in the quality of wound care. I want this to be a forum that sparks interest in alternative ways to think about how we approach healthcare with special focus on preventive strategy. Most healthcare providers want to see change but few are empowered to actually pursue it. YHC is striving to position itself as a catalyst for that change. Quality improvement shouldn’t just be limited to large academic hospitals with deep pockets who can afford to make a working system work better. We want to extend the knowledge and expertise to the rural hospitals, the struggling nursing homes, and the overburdened LTACs. We want to make sure that the sacrifices that healthcare workers make every day for their patients are actually worth it.

If you were in a room full of healthcare providers and you asked, “how many of you are frustrated with the way healthcare is delivered right now?”. I’m sure you could imagine a room full of hands going up. There’s a constant tango between providers, payers, and litigators all claiming to act in the best interest of the patient yet all accusing the others of not doing so. I can’t imagine that healthcare was originally designed to function like this, and I certainly did not enter the field of medicine knowing that the payers and litigators would be the primary regulators of my ability to practice. These provider level frustrations are extensions of system level failures and most of us in healthcare know it with limited knowledge of the tools to change it.

The failure starts at a national level. The United States ranks 1st in healthcare spending but last in outcomes amongst OECD nations. Some may not really care about this statistic because the superior medical technology that we produce and use is expensive, which leads to increased spending. One would imagine that this would mean a healthy population as well though. Clearly it does not, but why? I would posit that this is how the system is designed to work.

The US healthcare system is subject to benefits and risk of capitalism similar to every other system in this country. The benefit is that a good business model can mean great success i.e., large regional multi-hospital systems. The risk is that costs can increase and quality can decrease for the end user, the patient.

Take the example of Medicare/Medicaid (CMS) reimbursements. The current model is designed to reimburse facilities and providers for services, so the more services you provide, the more money you make. Simultaneously, CMS ask providers to prevent waste and abuse of the system by accurate billing and efficiency in patient encounters.

It requires a fine balance between earning as much income as possible to provide quality care and not making any significant billing mistakes that could cost you your practice and in worst case scenario, your freedom. So administrative spending goes up to ensure that billing is done correctly and ligation is avoided. Efficiency decreases because more steps are involved in ensuring that potential mistakes are mitigated. Morale from providers decreases because of the red tape that keeps them from just doing the best job they can. Now imagine, if CMS reimbursed providers for quality care and prevention as oppose to volume. Providers would be much less concerned about how much they billed and much more concerned about what the best treatments options are. The race for money would be based on providing the best quality and not just being busy.

At the state level, Maryland is the only one in the country that has a value-based healthcare funding system called the Total Cost of Care Model. This model focuses on giving hospitals population-based payments as oppose to volume-based, encouraging hospitals to partner with non-hospital providers for continuity of care, and empowering primary care providers to better serve their patients. Health promotion and disease prevention are the focus, resulting in an anticipated $1 billion in CMS savings over the first four years of implementation. This is ground-breaking and could be revolutionary if adopted by CMS nationwide. There are plenty of similar value-based models at the local and community level which typically apply a mix of public and private funds to provide high quality care.

The blueprint for improving how healthcare is delivered exist. YHC isn’t reinventing the wheel. We are simply lending that extra hand that institutions may need to implement proven strategies that will not only reduce cost but improve the quality of the care they provide. This is the purpose of any healthcare provider. Imagine a world where the sole concern of any individual or institution is to provide the best quality of care possible without any other red tape. Imagine the joy of the providers. Better yet, imagine the joy of the patients. sintomasdelsida.org This healthcare utopia does not have to be locked in our imagination. YHC hopes to help people realize this dream so that healthcare focuses much more on the promotion of health rather than the treatment of sickness.