Hospital leaders in Florida take on the competition
Weiss still publishes the “Straight Talk” newsletter, with an email version going to readers nationwide. “I haven’t missed a week in 11 years,” he says. Topics range from feelgood employee recognition stories to edgier commentary about health policy. Last July, Weiss spoke out in favor of an efficient, single-payer health insurance system built around preventive care.
Such a system would have “the dual positive effect of a healthier and more productive population,” he wrote, adding that health spending as a percentage of the nation’s gross domestic product (18%) would decline as a result, freeing up resources for education and other things.
“Rice bowls will be broken – profit margins of health insurance companies, tobacco producers and others benefiting from sickness will be slashed,” he argued. “But the overall good for society is undeniable.”
Weiss says he expected to be “pilloried” for his views but instead got positive feedback. “I’m apolitical in this role,” he says. “Having said that, the surrounding community is pretty Republican.”
About eight years go, three NCH nurses developed breast cancer around the same time. Each was in her 40s or 50s. None had been getting annual mammograms, despite being in a higher-risk age group. One died, and the others survived.
The experience impressed upon Weiss that there “was something we weren’t doing right,” he says.
NCH subsequently implemented a workplace wellness program, making it easier and cheaper for employees to exercise, eat healthy and seek preventive care. NCH, for example, picks up the full costs of colonoscopy screenings at age 50.
Employees now have lower blood pressure and cholesterol levels and reduced risk of disease, Weiss says. After an initial spike in costs, NCH has cut its spending on health coverage by half while keeping benefits affordable for employees, he says.
“In the last three years, we’ve saved $23 million. We haven’t raised our premiums in four years, and we’ve lowered them for single parents, who were already so stressed economically,” he says.
In 2015, NCH joined with Healthways, a Tennessee-based wellness program provider, to launch a community initiative to improve the health and well-being of local residents. The NCH-led Southwest Florida Blue Zones Project works with local employers, businesses, churches and schools to encourage people to adopt healthy diet and lifestyle practices.
Weiss says the effort could put NCH in a better position as the industry moves away from traditional fee-for-service payment models to value-based reimbursements.
In January, NCH will launch a Medicare accountable-care organization (ACO) with about 10,000 patients. If NCH can lower costs and produce good outcomes, it will receive a share of Medicare’s savings.
“I want to see fee-for-service go away,” Weiss says. “I think fee-forservice encourages me to make you sick.”
He acknowledges that a health insurance system based on prevention rather than treatment could leave some doctors feeling like the Maytag repairman — less necessary. “But it’s the right thing to do,” he says.
Recently, Weiss attended a community workshop designed to help people find their purpose in life — a key tenet of the Blue Zones project. Weiss says he had no trouble identifying what makes him go. “My purpose is to help people live longer, happier, healthier lives,” he says.
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