The military has always been on the front lines of technology, innovation, and medicine.
On the one hand, the demands are significant and the conditions are challenging. On the other hand, rewards for getting these things right can save lives and protect the country.
So when the military tests a brand new way of doing value-based care — I definitely pay attention.
Recently, the naval hospital in Jacksonville Florida launched an ambitious pilot project.
The goal, as Fierce Healthcare reports, was "to explore whether multidisciplinary care teams could improve the cost of care for active-duty personnel and their dependents."
The magnitude of the results of the pilot could be huge. As of 2019, the Navy spent $9.5 billion to deliver medical care to 2.8 million people (active duty personnel, retirees, and their dependents.) And the initiative was ambitious -- pioneering a multidisciplinary way to take ultimate accountability for the results and the costs for complex conditions.
The structure of the pilot was as follows:
- Two project managers met weekly to guide the program.
- Medical conditions with high incidence and spending were chosen: back pain, osteoarthritis, diabetes, and high-risk pregnancy.
- Each condition had a physician and nurse co-champion with an interdisciplinary team working closely together to plan and execute care.
The results were very promising. Results showed that care was better, costs were lower, and active-duty personnel got back to work faster.
Robert Kaplan, Harvard Business School co-author of the paper said that the results “demonstrated that no new medical advances or techniques are required to improve the health of these populations; just the need to better organize care around the patients’ conditions and treat them pro-actively with focused multi-disciplinary teams.”
What's fascinating to me about this project is that the military has an incentive to not only improve care and decrease costs -- but also to get personnel back to work as quickly as they can. In other words, it's a great demonstration truly considering all of the impacts of treatment -- care, costs, and the ultimate impact on the patient's life.
There were certainly challenges -- but the pilot showed the incredible value of working together, under an organized vision, and collaborating in multidisciplinary teams. These dramatic results could be transformative, certainly, for the military -- but it's possible they could be applied in many contexts with great results. “At a broader level, given the positive experience with this value-based health care pilot, the Navy’s implementation model could serve as a model for other organizations, including the Veterans Health Administration and those in the private sector, that are interested in new ways of organizing, measuring, and improving the care they deliver to patients,” the paper concluded.
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