Taking care of business means taking care of people

June 1, 2005

Maybe we're encouraged by recent steps forward to harmonize our disconnected healthcare system (through proposed health information networks, for example) but there is still so much more to do.

Maybe we're encouraged by recent steps forward to harmonize our disconnected healthcare system (through proposed health information networks, for example) but there is still so much more to do.

For my money, I agree with the advocates of the Swedish model, which emphasizes broader primary care. I'd love to see more primary care physicians granted the time to help patients coordinate the big picture of their healthcare-more time to review medication usage, preventive care, disease management and behavioral health issues-with less need to bounce patients back into the system with a specialist referral or another prescription.

No doubt you've skipped right past the PCP on occasion and looked up the number of the nearest specialist instead, telling yourself, "I'll just end up there anyway."

One advocate of the Swedish model is Colorado Access, a Denver-based Medicaid/ Medicare plan with more than 158,000 members. During our conversation in his office, CEO Don Hall told me that PCPs in this country function like Wal-Mart greeters today. They aren't compensated for comprehensive 30- or 45-minute visits, so they spend a good part of their day just greeting patients and referring them elsewhere.

"Our goal is to re-emphasize primary care," Hall says. "If we ask PCPs to spend more time with the patients, other plans could be pushing to reduce that. We all have to work together as an industry."

WORKING TOGETHER When Hall began leadership of Colorado Access, the organization's employee turnover rate was 40%. For Hall, that was unacceptable for a plan that cares for thousands of people with multiple health problems who need consistent support.

He sought inspiration. The management team read every book they could find about turnover and surveyed the employees. They ultimately discovered that some employees weren't connected to the plan's mission, and others believed that they didn't have friendship among co-workers.

To change that, management began fostering a friendly atmosphere with improved communication. Now, staff meetings are conducted like TV game shows with Hall as the host, and every Wednesday, a few employees volunteer to make popcorn for the entire company.

As another part of the business-philosophy changes that are more people-centered, all Colorado Access meeting rooms were named after great people, such as John F. Kennedy, Martin Luther King Jr., Jimmy Carter and even Dr. Seuss. The rooms contain pictures, quotes and insight from those inspiring icons.

Hall says he adopted the people-focused business philosophy of Southwest Airlines' leader Herb Kelleher after reading the book Nuts! "The company takes care of the employees, and the employees take care of the customers," Hall says. "I'm not the one who works the phones; it's rare that I interact with members. It's the employees who actually have that responsibility. We're going to take good care of them, and that is how we want them to take care of our members."

Even if the healthcare industry is still experiencing the cost and criticism brought about by its lack of harmony, the one unifying cause will always be caring for people. Sometimes those people are patients, sometimes physicians, and sometimes they're the people you pass in the hall every single day.

Julie Miller is managing editor of Managed Healthcare Executive. She can be reached at julie.miller@advanstar.com