The Case for Prevention

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Allina Hospitals & Clinics hopes its outreach program to prevent heart attacks in a Minnesota town will pay dividends for the system and community alike.

More hospitals and health systems are partnering with individual communities to provide preventive care and patient education in an attempt to alter disease-causing behaviors and, in turn, reduce health costs. But does it make much business sense for a provider organization to spend millions of dollars on what could be a futile attempt to change behaviors?

The organizers of one such effort, Minneapolis-based Allina Hospitals & Clinics’ Heart of New Ulm program, say yes. The program aims to reduce, and eventually eliminate, heart attacks in New Ulm, MN, over the next 10 years. The town in southern Minnesota has a population of roughly 13,600 people.

"The problem right now is that the payers for healthcare aren’t necessarily willing to pay much for preventive services because they are not really convinced that they work particularly well," said Jeffrey VanWormer, director of the Heart of New Ulm program. "There is a business case to be made that if we can get this to work and we can figure out how to do preventive services well beyond the walls of the hospital, then we’re pretty sure there is a market there that is willing to pay for that."

The Heart of New Ulm program combines public awareness and education to focus on early intervention and prevention of heart attacks. Although the program is still being formed, VanWormer says it will likely include a series of heart risk screenings for New Ulm residents and follow-up initiatives such as telephone or Internet-based counseling-type programs.

"We’ll also have kind of a traditional medical care model where we’ll refer folks to their medical provider if they are not quite getting the appropriate care that they need to be," VanWormer says.

The program is part of Allina’s $100 million Center for Healthcare Innovation established in June 2008 to support innovations in health research that can be translated to improved health for communities. VanWormer says the 11-hospital system’s efforts are also an answer to the pressure facing nonprofit healthcare organizations to be more involved in the community to validate their tax-exempt status.

"There are people in the government that say you guys aren’t doing enough, so Allina took a pretty hard look at itself and created the Center for Healthcare Innovation to do just that—to explore new and innovative healthcare services that are deliverable to entire communities versus just those that show up at the hospitals and clinics," VanWormer says.

VanWormer admits there are formidable challenges to changing an entire community’s behavior, but he is confident that combining an individual approach to healthcare with a community-minded one could make a difference. Heart of New Ulm organizers are trying to involve the entire community in the effort; the program may include initiatives such as working with restaurants and grocery stores to outline their food’s nutritional content, VanWormer says. A community health assessment is expected to reveal opportunities for further health improvement as well.

"By going after people proactively with these services while at the same time trying to change the policies in the environment of the community, we think that we can have an impact on the risk factors," VanWormer says. "And if we move those risk factors in the right direction, we will eventually have an impact on the hard events, like heart attacks or cardiac mortality."

Ben Cole

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