Bringing health care and nutrition closer together

Losing weight consistently makes the Top 3 for New Year’s resolutions. Closely related to this are pledges by Americans to exercise and eat healthier. According to a review of the most popular Google “how-to” searches made during the first week before and after New Year’s 2015, learning to cook healthier fare made the top 10, including kale chips (#2), lentils (#5), cabbage (#6), collard greens (#8) and broccoli (#9). Luckily for resolution makers, there are 3 developments in healthcare that will help them follow Hippocrates counsel to “Let medicine be thy food and let food be thy medicine.”

“What did you have for dinner last night?” Nutrition and the healthcare system

While we often hear about the role of good nutrition in promoting health, it is not typically discussed in the context of the Triple Aim – better outcomes, lower cost and improved patient satisfaction. What are the opportunities in health care to promote good nutrition and improve healthcare outcomes?

Strong patient-provider relationships drive healthier outcomes

Maybe there is a way to measure quality so that metrics better represent outcomes that matter.

Harvard Medical School’s Center for Primary Care has been studying exemplars in primary care through a series of case studies in the past two years. Their article in Harvard Business Review describes the finding that good outcomes are related to the strength of relationship between the primary care provider and patient. This finding is strong and consistent across all primary care exemplars in their study.ⁱ

Why Primary Care Should Pay Attention to Continuity of Care

Reducing healthcare costs through better care delivery begs the question: “Where do we start?” When the goal includes something to the effect of “the greatest possible improvement for a population,” it is good to reflect on the body of evidence pointing to high performing population health outcomes.

The work of Starfield and others is instructive: High performing health systems have high performing primary care as their foundation. High performing primary care has four cardinal features:¹

Singapore Ranks #1 in Healthcare Efficiency, but Not Primary Care – What Are the Lessons for the U.S.?

In 2014, Singapore achieved the top rank among 54 industrialized countries for healthcare efficiency. The United States ranked 44th. Singapore’s average life expectancy of 82.1 years and a per capita healthcare cost of only $2,426 (4.5% of GDP) earned it top billing. The average life expectancy in the United States is 78.7 and the U.S. reluctantly boasts the highest per capita healthcare expense of $8,895, accounting for 17.2% of GDP.

Should the U.S. adopt Singapore’s approach to the financing and delivery of health care, and if it did, would it achieve the same outcomes and similar quality? First, we need to understand what makes Singapore so different.

Why Would Anyone Care about Solo and Small Primary Care Practices?

Maybe solo primary care practices are dying, but so what?

This question led some folks at Mathematica Policy Research to look into solo primary care practice and the results are interesting.¹

They looked at a handful of states and found that the ratio of solo and very small practices varies quite a bit but represents a significant proportion of practices.  While on average 13 percent of primary care physicians practice solo, this represents 46 percent of practices.  65 percent of practices have one or two physicians.