Internationally Known Health Reform Expert Addresses SVHC Donors


15 October 2012
SVMC Media Contact: Eileen Druckenmiller, 802-447-5558
DHMC Media Contact: Rick Adams (603) 653-1913
MANCHESTER — Dr. Gregg Meyer, chief clinical officer and executive vice president for population health at Dartmouth-Hitchcock and an expert in health reform and population health management, gave members of Southwestern Vermont Health Care’s (SVHC) Equinox Circle leadership giving society a glimpse of the future of health care at the group’s annual reception Oct. 10. The event was sponsored by the SVHC Foundation. In a brief talk followed by questions, Meyer laid out a vision for “creating a sustainable health system,” one that provides high-quality patient outcomes at lower cost.
“The partnership between Southwestern Vermont Health Care and Dartmouth-Hitchcock is exciting,” he said. “The nation is looking for answers about reducing health care costs and improving quality. We have a unique opportunity in northern New England to lead the way and create the model of care for the entire country.”
Meyer went on to detail how health care was not deliberately structured as it is today, but has instead evolved over 200 years. In the past two decades, he explained, the cost of health care has rapidly exceeded the additional benefits to patients. “This is what economists call ‘the point of diminishing returns,’” he said. The answer is to reformat health care to focus on sustainability, which, he said, will require four key efforts.
First, we must do a better job caring for people at the end of life. “In America, we spend an incredible amount of money on people during the last two years of life,” Meyer explained. “Most of this is spent on hospital care.” Most Americans say they wish to die at home; however, most actually die in the hospital. “We need to do a better job of helping people have a good death, the type of death they want,” he explained.
At the time Meyer joined Dartmouth-Hitchcock, he was told about an exciting new partnership with a health system in Vermont.
“They were explaining the partnership, but assumed that I had never heard of Southwestern Vermont Health Care,” Meyer said. “In fact, I told them, I know that health system very well. My parents live in Cambridge, N.Y. Southwestern Vermont Health Care gave my mother what most Americans want and what few achieve: a good death. What I mean by that is a death at home, comfortable, and surrounded the people who loved her.”
“It’s not you who should thank me,” said Meyer to Thomas Dee, SVHC’s president and CEO. “I should thank you for the outstanding care you provided my mother during her last days.”
Meyer continued: “We also must do a better job of taking care of the sickest patients,” which he explained are those with multiple chronic or life-threatening diseases, such as diabetes, heart disease, and cancer. “Five percent of the sickest people in America use 50 percent of health care resources,” Meyer said. “And if you and I live long enough, we will be that five percent.” The solution, in part, is to create innovative community health programs that provide a wide range of care in the home. More robust community health programs will help people manage multiple chronic diseases, avoiding repeat visits to emergency rooms and hospitals.
In addition to helping the sickest patients to better cope, health care must re-embrace oral and mental health. Meyer explained that in many communities, tooth pain from cavities is a top reason children visit an emergency room. Cavities are easily preventable through relatively inexpensive interventions, such as regular cleanings, fluoride treatment, and protective coatings.
Likewise, the accessibility of mental health services leads to a high number of emergency room visits. Many patients and families, even those with good insurance, struggle to find coordinated mental health services and must patch together care from what is available.
Lastly, Meyer said the system must focus on ensuring that everyone has a primary care physician, particularly those who may have an undetected illness. “We must find those people who have high blood pressure or diabetes before they have a stroke or a heart attack,” he explained. Doing so, he added, is obviously better for patients, but it costs less, too.
Beyond these four health care challenges, Meyer explained he expects health system to reach beyond traditional health care. He said personal health is a mix of factors: choices, such as diet, exercise, and smoking; environment, including income, stress, pollution; genetics; and the health system. Changing the health care system to deliver better value is the first step. To truly improve health, traditional health care systems must collaborate more with the community to encourage healthier choices and create a healthier environment.
ABOUT SOUTHWESTERN VERMONT HEALTH CARE: Southwestern Vermont Health Care is a non-profit, integrated health system serving communities in Vermont, New York, and Massachusetts. SVHC is made up of Southwestern Vermont Medical Center, the VNA and Hospice of SVHC, the Centers for Living and Rehabilitation, the SVHC Foundation, the SVMC Northshire and Deerfield Valley Campuses, and Southwestern Vermont Regional Cancer Center. Southwestern Vermont Medical Center is Vermont’s first Magnet hospital for nursing excellence and home to the region's only breast care program fully accredited by the National Accreditation Program for Breast Centers.
ABOUT DARTMOUTH-HITCHCOCK: Dartmouth-Hitchcock is a national leader in patient-centered health care and building a sustainable health system. Founded in 1893, the system includes New Hampshire’s only Level 1 trauma center and its only air ambulance service, as well as the Norris Cotton Cancer Center, one of only 40 National Cancer Institute-designated Comprehensive Cancer Centers in the nation, and the Children’s Hospital at Dartmouth-Hitchcock, the state’s only Children’s Hospital Association-approved, comprehensive, full-service children's hospital. As an academic medical center, Dartmouth-Hitchcock provides access to nearly 1,000 primary care doctors and specialists in almost every area of medicine, as well as world-class research at the Audrey and Theodor Geisel School of Medicine at Dartmouth.