1 MICHAEL D WILLIAMS MD FACS DIRECTOR OF

  • Slides: 33
Download presentation
1

1

MICHAEL D. WILLIAMS, MD FACS DIRECTOR OF THE CENTER FOR HEALTH POLICY THE FRANK

MICHAEL D. WILLIAMS, MD FACS DIRECTOR OF THE CENTER FOR HEALTH POLICY THE FRANK BATTEN SCHOOL FOR LEADERSHIP AND PUBLIC POLICY ASSOCIATE CHIEF MEDICAL OFFICER, UVA HEALTH SYSTEM ASSOCIATE PROFESSOR OF SURGERY AND PUBLIC HEALTH SCIENCES

SOCIAL IMPERATIVE • The Great Question: How do we make Health and Wellness: •

SOCIAL IMPERATIVE • The Great Question: How do we make Health and Wellness: • Achievable • Equitable • Sustainable For every American? 3

 Too Fat to Fight: Is the Obesity Crisis a National Security Risk? by

Too Fat to Fight: Is the Obesity Crisis a National Security Risk? by Andrea King Collier 4

"By the year 2020, only two out of every 10 recruits will be able to meet the weight-fitness qualifications to serve. " — Dr. Gregory Poland" According to Poland, "one in three young adults of military recruitment age in the United States is too overweight to enlist. "In fact, obesity and overweight is the No. 1 cause of ineligibility in the armed services, " he says. "By the year 2020, only two out of every 10 recruits will be able to meet the weight-fitness qualifications to serve. " 5

Patient Goals Ex es m o pe ns Payer Expense s 6 es Value

Patient Goals Ex es m o pe ns Payer Expense s 6 es Value tc u O Provider Costs

7

7

8

8

9

9

10

10

11

11

12

12

Per Enrollee

Per Enrollee

Second… Social Determinants of Health

Second… Social Determinants of Health

 • Availability of resources to meet daily needs (e. g. , safe housing

• Availability of resources to meet daily needs (e. g. , safe housing and local food markets) • Access to educational, economic, and job opportunities • Access to health care services • Quality of education and job training • Availability of community-based resources in support of community living and opportunities for recreational and leisure-time activities • Transportation options • Public safety • Social support • Social norms and attitudes (e. g. , discrimination, racism, and distrust of government) • Exposure to crime, violence, and social disorder (e. g. , presence of trash and lack of cooperation in a community) • Socioeconomic conditions (e. g. , concentrated poverty and the stressful conditions that accompany it) • Residential segregation • Language/Literacy • Access to mass media and emerging technologies (e. g. , cell phones, the Internet, and social media) • Culture 18

20

20

21

21

-Healthcare Financial Management Association website 22

-Healthcare Financial Management Association website 22

23

23

FUTURE STATE • • 24 State Governments will likely have More Control State Spending

FUTURE STATE • • 24 State Governments will likely have More Control State Spending on Health Care will continue to increase Social Determinants will continue to have an outsized impact on expenditures Opportunities/Imperatives for Creative Programs that Mitigate SD’s • • =More Risk =Likely Greater Disproportionate Spending • =“Healthcare” Dollars may need to spent Indirectly =Public/Private/Academic Partnerships may be the path forward •

Public social expenditure by broad social policy area in percentage of GDP, 2003 –

Public social expenditure by broad social policy area in percentage of GDP, 2003 – OECD 25

Public and private social expenditure in percentage of GDP, 2009 – OECD 27

Public and private social expenditure in percentage of GDP, 2009 – OECD 27

28

28

29

29

30

30

31

31

33

33

SOLUTIONS • • • 36 Educate Providers – Costs of Therapies (Robotics) – Value

SOLUTIONS • • • 36 Educate Providers – Costs of Therapies (Robotics) – Value Points/patient/population Educate Policymakers – Value Point – Comprehensive Cost of new Policies (HIPPA, MACRA , etc) Educate Patients – Goal-sharing indexed to Value Point/ Therapy – Right-size Expectations (Everyone Dies Rule) – Direct, personal and shared COSTS!!!!( No Free Lunch…)

37

37