Opinion: Saint Francis Health System transforming patient care through new Medicare program

Early December is always a special time for me. The first Saturday of the month, on Saint Francis Serves Day, volunteers from Saint Francis Health System fan out across communities in eastern Oklahoma for a day of service to nonprofit agencies that aid the most vulnerable people in our communities.

Seeing these volunteers at work is important to us as an organization — and to me personally. It's an example of our commitment to the places in which we live and work, whether that happens inside our hospitals and clinics or in our free time in the neighborhoods where we live.

The spirit of Saint Francis Serves Day is anchored in who we are as an organization — one driven by shared values that guide what we do every day. Those values are also what we lean on as we tackle some of the biggest challenges we face in an ever-evolving health care landscape.

This brings me to a key point about where we're headed next. In an effort to improve the quality and affordability of the health care services we provide to our Medicare patients, Saint Francis will be participating in the Medicare Accountable Care Organization beginning Jan. 1.

For us, this will allow us to more meaningfully partner with 25,000 Medicare patients in eastern Oklahoma. Under the Medicare ACO program, Saint Francis is joining other leading health care organizations across the country in committing to delivering measurably higher-quality health care while reducing the number of unnecessary, often harmful and expensive health outcomes that Medicare patients sometimes experience.

This represents a major change in how health care is delivered and paid for. Historic health care payment sometimes leads to siloed treatment; within the ACO program, health care providers are incentivized for coordinating a patient's treatment plan, as well as delivering care in new and innovative ways to assure the best possible patient outcome.

We see this as a crucial step for the health of the region, but it is one that comes with formidable challenges.

Storm clouds are on Medicare's horizon. The most recent report from the Board of Trustees of the Federal Hospital Insurance Trust Fund shows that the program's costs are outstripping its funding. Current trends show that unless significant changes are made, Medicare will run out of money by 2031.

This is why it is imperative for leading health systems to do their part to reduce costs and improve outcomes.

Other hurdles are more local. Current health outcomes in Oklahoma show a population weighed down by serious preventable diseases.

According to the most recent figures from the U.S. Centers for Disease Control and Prevention, Oklahoma has the nation's highest death rate from heart disease. About 11,000 Oklahomans die from heart disease annually.

Oklahoma's high death rates from other conditions are similarly daunting: Nationally, we rank second in death rates from lower respiratory illness (a combination of COPD, asthma, emphysema and chronic bronchitis), fourth from cancer, fifth from diabetes and 20th from stroke.

Between 2016 and 2030, the overall price tag for chronic diseases in Oklahoma is projected to hit $518 billion, according to the Partnership to Fight Chronic Disease.

You read that right: half a trillion dollars.

Clearly, the outsized prevalence of these diseases in our population is costly to patients, health care providers, employers and taxpayers.

Reading this, you might be wondering why we're anxious to work with a federal program facing such serious fiscal headwinds while simultaneously taking on some of the sickest patients in our state. The answer lies in the idea of serving our communities by being part of the solution. As eastern Oklahoma's only locally owned health system, this is personal to us.

As we enter the Medicare ACO program, Saint Francis is expanding its resources and programs with an eye toward helping patients more rapidly identify and prevent the onset of disease.

When chronic illness is evident, teams of our caregivers will look toward proactive care and support while making sure the right care is delivered at the right time and the right place. Clinical teams will coordinate with each other and educate patients with the goal of avoiding duplication of services.

Already, we are expanding our capabilities to deliver care into settings more convenient for patients, even bringing some services to their homes.

Doing this within the framework of a Medicare ACO will allow us another way to deliver higher quality care while assuring our collective health care dollars are being spent more wisely.

Down the road, Saint Francis intends to use this as a blueprint for our non-Medicare patients. If we're successful, we could see an even broader positive impact on patient outcomes that will benefit not just patients, but employers and taxpayers, too.

We recognize that there is an underserved population in eastern Oklahoma that needs better access to innovative, proactive care. We also know there is a need to not only be good stewards of public funds that are part of the Medicare equation but also of our position as the region's largest health care provider.

My desire is to see the values displayed by our Saint Francis Serves Day volunteers be a small reflection of what we do every day throughout the health system. I believe that has been true in the past and is true now.

This latest opportunity — one filled with challenges and complications, but also the potential for great good — is a chance to show that once again.

Cliff Robertson is president and CEO at Saint Francis Health System.