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SALT LAKE CITY — Gov. Spencer Cox announced a new health care initiative on Thursday that he calls "one of the most transformative and visionary health care efforts in all of the United States."
The initiative aims to reduce health care costs and keep them from outgrowing the economy, improve health care outcomes, close gaps in health care and improve quality of life. The government will initiate a public-private partnership called the Utah Sustainable Health Collaborative, which will center on patients' needs and will include leaders in health care, insurance companies and businesses. This collaboration will be more than a think tank, Cox said, and will have the ability to act.
"It is big, and it is bold, and it will take all of us working together to accomplish," he said.
Cox challenged the community to initially limit the growth of health care costs, and eventually reduce that growth so that the cost of health care does not exceed economic growth, while continuing to provide a high quality of care. The collaborative will help to facilitate that goal by creating innovative solutions. There are initiatives across the state, Cox said, that could help if they are shared and used on a wider scale to collectively address issues.
During the COVID-19 pandemic, health care workers and businesses worked together in ways that they hadn't previously. Additionally, the pandemic brought more attention to inequitable health outcomes, especially in rural areas, Cox said, adding that these experiences helped develop this plan.
"I believe that we have an opportunity right now to rethink the way our whole health care ecosystem works in serving Utahns. Because of what we've learned over the past year and a half about the power of collaboration and reaching beyond our customary boundaries, I'm confident we can accomplish what we're going to be proposing today," Cox said.
The governor said health care costs have continued to rise at an unsustainable rate, much higher than the rate of inflation. Health care premiums have outpaced wages by 17%, according to Cox, and that additional cost is paid by both employees and employers. Additionally, 66% of bankruptcies are tied to medical issues.
But health outcomes have decreased despite the added money being allocated, and inequities in health care are expanding. Cox said that the system has to focus on health, and not just health care, working to address prevention instead of focusing only on treatment.
"In South Salt Lake, for example, life expectancy is a full 10 years lower than just three miles to the east. We have to do better," Cox said.
Cox said that he understands that government has tried to fix health care multiple times before, but he said that he thinks that with this collaboration, Utah can make a difference and provide better health care. He expects that for this program to be successful there will need to be hundreds or thousands of changes from various groups.
"We can do this. Utah is different, guys, we really can make a difference if we will come together. But you have to leave your biases behind. You have to leave your preconceived determinations about how this is going to end behind. You have to leave some of your biases against your competitors behind. You have to leave some of the baggage behind that has been here before.
"And if you'll do that, if you'll really leave that baggage behind, and if you'll just try, just come together, we'll knock down walls to make this happen," he said.
The collaborative will also be tasked with helping develop a 15-year plan for health care sustainability. Cox said the collaborative will not be driven by its funding source, but instead by a desire to help Utah residents. According to Cox, over the next decade, health care costs for Utah are projected to rise so much that they will affect state spending priorities, stunt Utah's economic growth and harm private companies' profits and employee wages.
"Transitioning to a focus on health instead of health care will take time, but is one of the most meaningful and economically essential legacies we can create for Utah's future. We want to make incremental informed changes across the health care system and we want to evolve thoughtfully," Cox said.
Some projects Cox suggested the collaboration may take on include integrating behavioral and physical health, addressing social determinants of health and the expansion of successful opioid initiatives.
Dr. Mary Jane Pennington, president and CEO of Granger Medical Clinic, one of the state's largest independent physician-owned clinics, spoke about some of her experiences improving health care for their patients.
"As a physician, no one needs to tell us that the health care system is broken. We spend all day long in exam rooms talking to patients," Pennington said.
She talked about having patients who do not take their prescribed medicine frequently enough, or who do not understand directions from their doctor and as a result are not able to address their health problems.
"The United States spends more than any other developed country on health care and all the standard metrics of health care, infant mortality, life expectancy, we're at the bottom among other developed countries," Pennington said.
Pennington said Granger medical has tried to improve health care by reminding patients about follow-up appointments and yearly checkups, using pharmacists to help find more affordable prescriptions and reaching out to patients after a hospital stay to talk to them about care. Pennington said they saw a 15-20% reduction in re-admissions to hospitals simply from reviewing medications with patients and helping them schedule follow-up visits.
She said that this government initiative could help their organization by increasing the collaboration involved in their efforts and possibly through helping fund these and other programs until they are proven to be successful and insurance companies may begin to support the programs. Additionally, she said that this collaboration could help consolidate the data and measure outcomes of initiatives more effectively.
"I know that all of us involved in the delivery of health care, everybody I talk to, shares common goals. We want to help our patients be healthier in a more cost-effective manner, and I firmly believe that working together to solicit ideas to work together to share what has worked and what hasn't is the way we're going to solve this problem," Pennington said.
Amanda Covington, representing the Larry H. Miller Group of Companies, said that this initiative could also help businesses who spend a significant amount providing insurance to their employees. In Utah, Covington said, 60% of individuals have commercial health insurance which is typically paid for in part by employees. In Utah, companies are the largest purchaser of health insurance, not the government.
She said having employees who are living healthy lives and have the care and support they need is essential for companies, because it allows employees to be engaged in their work. Covington said it is important to make sure that businesses are at the table for these conversations.
"Our company, Larry H. Miller Group, is all in and we're looking for everyone else in the state to join us in this important initiative," Covington said.
Cox explained that since the collaborative will be a partnership between public and private organizations, they will be able to combine what the government has learned through Medicaid with innovations from private companies and help save government money along with helping businesses. As the ideas are tested and found successful, they can be implemented quickly on a large scale through both the private and public sectors.
"Let's put all the garbage behind us, and let's work together and let's see if we can make something happen," Cox said.
Rich Saunders, Utah's first chief innovation officer, has been working to build this initiative. He said that they have received feedback from dozens of experts and influencers, and many have committed to helping the initiative succeed.
"We are going to change the world in Utah," Saunders said.
He said that an advisory board for the collaboration will be built by the end of January, and then in the next few months the collaborative will be designed and a governance team will be established. The hope, Saunders explained, is that by June or July 2022 the collaborative will be launching initiatives.
Because the collaborative is hoping to start with projects that are already being used, both in Utah and elsewhere, Saunders asked individuals to go to their website and submit ideas. These ideas can be suggestions for people to be involved with the collaborative and for initiatives that could help change the health system in Utah.
"It's bold, and it will be disruptive, but I think … as long as we're coming together and united in this effort, we can go somewhere special," Saunders said.
