Dylan Ratigan Show   |  June 19, 2012

Hot-spotting can lead to more effective, affordable health care

MSNBC’s Dylan Ratigan talks with Martha Lefave, health fund coordinator at Local 49, and Naomi Wyatt, director of legal and government affairs at the Camden Coalition of Health Care Providers, about the practice of hot-spotting in health care and how it can improve the health care system.

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This content comes from Closed Captioning that was broadcast along with this program.

>>> now through friday, we wrap up this phase of our journey. we are getting ready for the next, when ultimately, my goal and i hope yours along with everyone else, will be to take everything that we have been taught and learned here on the dr show over the past three years and begin to turn it into action as so many community heroes have done. throughout the week, we're introducing or reintroducing the community heroes who proef we can get a lot more for a lot less by changing the culture of how we work with each other and delivering results that make you go wow. today's wow stat, better outcomes for lower costs. the international union of operating, a union health network adopting new practices. insurance costs were rising nearly 11% each year. over all, they felt 10% during the three year time, anybody can cult health care costs. it's not that hard, but to reduce health care costs while increasing health outcomes never happens. how? the unions have identified the members whose health care costs the most and then is set about developing custom plan to approve their health at a fraction of the price. think of it as first step practices. familiar to a lot, but we've got the how and the wow. the question is how do we do more of it now? breaking it down with us, mark, alo along with naomi, who's director at the camden coalition of health providers. and one of the first really pioneer this idea of hot spotting in health care to identify the sick first and customize plans to crete them. martha, why do you think we're not seeing more people do this where you can save money in a health care network and at the same time, increase your health outcomes. and how to help them become healthy. why are we not seeing more of that?

>> that's a good question. you look at the patients themselves when they're dealing with a health care issue, it's overwhelming for them and their families. you go to the internet -- good outcome, that's what we did. took them by the hand with a program and gave them the information. i think it's available out there. i think there's access to this information through programs that really help individuals to get there. i don't know why it's not happening.

>> it's not a rules and regular laces, almost like a culture problem. the tool to do it is actually deciding it before your plan your health care . replan, plan, plan, all the medicine, all the things we're going to do, but we're doing this planning, but if we were in the marine corps , they would laugh at us. you and dr. brener have been pioneers and you probably have a better sense is so, why we're so slow to see the change you're modeli modeling.

>> i think a lot of i have has to do with the fact that health care is reactionary, so if you think about your doctor's office, you call and you go when you're sick. now, if your doctor's office were like any other company in the world, it would be proactive in getting to you before you're sick, right? you know the airlines know your flight patterns amazon knows everything you buy hours before you buy it. and what a doctor's office needs to be is a paradigm -- and like the local union did, identify ing those people who need help instead of having them go to the emergency department where the care is going to be much more coa costly.

>> it's amazing when you get and understand really how simple it is, if you find the right people who need the most help may become healthier and health care costs go down, are you impressed by the old culture, is it preserving itself even though it doesn't cost a lot of money.

>> i think that we really need to educate. people need to be more educated. making sure that they're educated, access and make good information about the decisions. about the treatment plans they're given. they're number one in a decision making process for health care .

>> most of us in the world are not a member of the 49ers union. they're not a beneficiary with dr. brener and there's other examples of this, sort of new thought in a world of, if you look at the accessibility for more -- any other normal, say healthy patient, the type of information that's out, that you are kcustodians and nobody's walking in the room saying, you've got to get in front of these three problems as you were saying. if we want to be healthy and we're bankrupting ourselves paying for health care , why are we not toing this.

>> because it's hard. i think martha said something very important and she used the word we reach out and we give people hand. to do this work takes proactive, thoughtful work and you have to reach out and touch the people that need the most help. it's far easier to do things that are an inch deep and a mile wide for example you know, calling everybody on the phone and reminding them to take their vitamins. that's cheap and easy. you can have people in a phone booth doing that. i think you need to fundamental fundamentally change the way you deliver care. our system isn't set up to incentivise providers to behave that way. doctors are encouraged just to run from room to room. that's what they're paid to do. they're not paid to be proactive.

>> once as the culture changes, ultimately, the way we mission, direct and compensate our health professionals is out of the line with the culture the two of you are practicing right now, it seems. fair?

>> yes.

>> thank you for teaching me and i hope to continue to learn more about this and help others learn how to do it. and it's really actually inspiring because you can get frustrated and think there's nothing to be done and meet you two and oh, they're already doing it. so thank you gois and congratulations for showing us how to get stuff like this done.

>> thanks, dylan.

>> thank you.

>> check them out on the internet. camden coalition and the 49ers union. next up here, some "hardball." new campaign strategy for the president, to go where the gop can follow. could women's rights, gay marriage and immigration reform be the democratic ticket? chris is next, but first -- he's taken on bp, the pentagon and nr ark, so what topic has david chosen for his land and final rant? [