Burr's prescription: Get healthier with a medical home

by Tom Campbell, Executive Producer and Moderator, NC SPIN, March 21, 2014.

Senator Richard Burr understands that America’s greatest challenge is healthcare and has made it his personal mission to help find solutions to our broken healthcare system. He travels the state seeking input from health professionals and patients, studies new approaches, even offering substitute proposals to The Affordable Care Act. This is obviously more than politics with Burr.

In 2012, there were a reported 120 independently owned community hospitals in North Carolina but that number has shrunk by more than a dozen, a growing trend. The urge to merge is occurring for many reasons but the biggest is growing financial pressures resulting from implementation of The Affordable Care Act, rising unpaid fees due to uninsured care and unreimbursed Medicaid and Medicare charges. Burr recognizes independent hospitals are struggling, saying that four community hospitals in Georgia have closed their doors. Many believe it more attractive to seek a larger umbrella to shelter struggling balance sheets.

But is bigger better when it comes to healthcare? There is evidence that suggests costs to patients increase and a Booz and Company study indicates one in five hospitals went from having positive margins to negative ones following mergers.

Senator Burr talks about the increasing use of hospital emergency departments saying the emergency room is not the place to practice primary care or for checkups. The Senator told of a new trend where hospitals create places where patients who don’t have a primary care physician can go for care. "And then tell them you don’t get to go to the emergency room anymore. You go through this door and they will take care of you,” Burr explained. "You do it with existing staff in an existing building using existing technology. It is really no additional cost just to see if managing their health care, do we make more money and do we eliminate the case load in the emergency department.”

In a tour of eastern healthcare facilities earlier this week Burr told The Wilson Daily Times, "I’m going to be honest with you, I’ve figured out a lot of things in health care but I haven’t figured out at the end of the day how to financially make this work unless we can manage the American people’s health care in a way that they’re healthier.”

Burr says that means getting sick people well faster and patients with chronic illnesses, like diabetes, obesity, high blood pressure and high cholesterol onto maintenance programs. “I’ve never seen it done without creating a medical home that people have,” he emphasized. That’s a model that Community Care North Carolina has used successfully in our state and is at the heart of Governor McCrory’s new Medicaid reform proposals.

It sounds simplistic. The best way to return our healthcare system to good health is for our people to be healthier, and the best way to ensure people are healthier is for them to have a personal physician and a medical home where they treat symptoms before they become serious, where preventive medicine is practiced and chronic care is kept manageable.

Senator Burr is correct in saying this is the best approach to keeping our healthcare system intact for the next generation and ensuring innovation in healthcare continues. We should follow his prescription.