March 1, 2015

Healthcare in America – Part II: A Changing System, a New Set of Rules

Healthcare in America, Jared DuPree

By Jared DuPree, PhD, MBA

Note: This is the second article in a six part series by Dr. Jared DuPree addressing healthcare in America. Look for it in each issue of St. George Health & Wellness magazine through 2015.

If you didn’t read the first article of this series, Click here to read Heathcare in America – Part I: A New Way of Thinking

Unfortunately, new thought doesn’t always lead to change, especially in intricate systems like healthcare. However, we are currently experiencing a tipping point. Enough physicians, consumers, organizations, and scholars have brought enough innovative thought and demand for change to the table that change is actually occurring. There are several forces at play that are changing “the rules” of how we address healthcare.

First, insurance companies realize that a minority of patients are costing them the majority of overall expenses. These companies are beginning to ask if we can somehow help people be healthier. This is important. This is also different. For the first time in our healthcare system, insurance companies are beginning to reimburse providers based on how healthy they can keep them.

Second, because insurance companies want to reward providers for keeping patients healthy, they are changing how they reimburse. Insurance companies are beginning to pay providers better if they keep their patients healthier. Providers are both relieved and concerned. They are relieved because they can focus on what really works long-term. They are concerned because many insurance companies are reducing or even dropping reimbursement for costly procedures. Overall, the new rules incentivize providers to add more services to improve health. Research is suggesting that components like nutrition, fitness, behavioral health, relational health and even career planning or stress management can greatly reduce factors that lead to disease and improve overall wellness.

From an economic standpoint, consumers are being given more options to pay for their healthcare. Health savings accounts and flexible spending accounts combined with high deductible plans are becoming much more common. These type of accounts help people save money through tax benefits and also give them more choices on how to spend money on healthcare. In addition, it motivates consumers to be healthy because they don’t want to spend money on costly procedures.

Finally, corporations are also becoming aware that healthy, happy employees improve productivity and company success. Many companies are forming in-house wellness programs or adding programs like LiVe Well, Alive & Well, and WholeFIT. They can’t rely on the healthcare system anymore; they are taking it on themselves because they realize it will improve the bottom line. When business gets involved, innovation often comes more rapidly.

Overall, some of the new rules of the system are allowing healthcare to become what it should have been all along – a system that actually helps us be healthy and well. With so many doors opening and opportunities ahead, I hope we can take advantage of what is being offered and get it right.

  • New Rule #1: Insurance companies, Medicare, and Medicaid are extremely motivated to help patients be healthier because it saves them money.
  • New Rule #2: Providers are more motivated to provide services that improve overall health and wellness and prevent sickness.
  • New Rule #3: Health savings accounts, high deductible plans and concierge medicine is making it possible for consumers to save more money and get better care while incentivizing them to be healthy long-term.
  • New Rule #4: Corporations realize that healthy, happy employees means better productivity and company success; corporate and business innovations are leading to rapid improvement in how companies take care of employees which are leading to innovative services, technologies, and solutions.


Next Issue: New thinking, new rules – what does it mean to me?


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