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Implementing Health Care Reform

Dean Kenneth S. Polonsky, MD Kenneth S. Polonsky, MD

The University of Chicago Medicine, along with other health care providers, is moving ahead with changes under health care reform following the U.S. Supreme Court’s decision in June upholding the Patient Safety and Affordable Care Act of 2010.  Not since 1965, when the Medicare and Medicaid programs became law, has the nation faced a more monumental shift in health care.

Fulfillment of the Affordable Care Act will produce many changes. Among the first is a significant reduction in the number of uninsured Americans, which eventually will improve public health and lower costs.  As more people obtain health coverage, there is a responsibility for providers to use scarce resources in the most cost-effective manner possible.  In Illinois, where a state fiscal crisis recently led to reductions in Medicaid payments to providers, it is critical that we focus on delivering appropriate care in the right places and at the right time.

To address these challenges, health care providers must support innovative approaches to patient care that produce the best outcomes while keeping a lid on costs.  The ideal that all Americans should have access to care regardless of health status or income means that near-term logistical and financial realities must be addressed by the public, the state and health care providers.

A number of initiatives at the University of Chicago Medicine will facilitate the delivery of high-quality patient care and improve public health while controlling costs.  For example, the South Side Healthcare Collaborative connects patients seen in our hospitals with community health centers.  This focus on care coordination meets the needs of patients, improves quality of care and lowers readmission rates.

The Center for Medicare & Medicaid Innovation, established by the Affordable Care Act, is encouraging novel models to transform health care.  CMMI recently announced the intention to award grants, including two to University of Chicago Medicine faculty, to support local initiatives that aim to deliver better care and improve health at lower costs.  

One initiative, led by David Meltzer, MD, PhD, will focus on Medicare patients at high risk of hospitalization by offering a personal physician to care for them not only when they are hospitalized, but also when they leave the hospital.  Under this new Comprehensive Care Program, these patients will receive continuous care from a physician who knows them, which will improve care and patient outcomes while lowering costs.  

Another project, CommunityRx, led by Stacy Tessler Lindau, MD, will deliver personalized information about community resources for wellness and disease management as part of the doctor-patient encounter.   New health information technology systems will support self-care by promoting use of community resources and linking local health and human services organizations with information they can use to tailor their programs and services.

These kinds of innovative solutions aim to create a healthier, better-resourced population cared for by committed community physicians, rather than those based at hospitals, thus saving Medicare and Medicaid millions of dollars annually.

The resources of an academic medical center, available at the University of Chicago Medicine, allow us to test new models to solve difficult problems.  We are working with the communities and people we serve to create a strong health care system that directly addresses the needs of our patients.

Kenneth S. Polonsky, MD
Executive Vice President for Medical Affairs, University of Chicago Dean, Biological Sciences Division and Pritzker School of Medicine