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Health Reform and John Wesley Powell - Health Care Editorial

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Dear Health Care Leader,

We all knew we were in for a bumpy ride when the Patient Protection and Affordable Care Act was signed into law in 2010. As we continue our journey, I can’t help but be reminded of an explorer who passed through Colorado nearly 150 years ago on his way to Green River, Wyoming.

Prior to Major John Wesley Powell’s expedition in 1869, there was widespread belief that no one who ventured down the Colorado River would ever emerge from it alive. However, Major Powell and nine other men embarked on a journey that would prove this belief false and forever change the West.

In writing Powell’s biography, Pulitzer-prize winning author Wallace Stegner remarked, “I have been able to conclude only that Powell’s party in 1869 survived by the exercise of observation, caution, intelligence, skill and planning.”

I believe that such a combination of observation, caution, intelligence, skill and planning is also the key to our ability to thrive as the health care system is transformed.

As we are all painfully aware, media outlets have produced a relentless stream of stories demonizing hospitals for
charges, billing practices, mergers, alignments, CEO compensation and excessive profits. We know that increased
scrutiny and examination of our clinical and business practices is the new norm—but we are not helpless.

CHA is one of the few state hospital associations in the country proactively studying this issue. Earlier this year, your
board established a Chargemaster Task Force to develop recommendations and guidance in regards to hospital
billing practices. It’s a complex process, but I’m proud to say that Colorado hospitals are stepping up to the plate.

Hospitals have the unique distinction of being one of the most visible symbols of both what is right and wrong with
the health care system. Without question, our curative powers and abilities are the best in the world; however, we
are also viewed as the most costly and uncaring. So how can we get the public to view us from a different

We must work to improve what we do by focusing on patient safety, lowering costs and spending less. As I envision
the future, I see a system that is not only viable, but vibrant. It includes:

  • A healthier population of empowered patients;
  • Improvements in the prevention, treatment and management of chronic conditions;
  • Engaged consumers who will hold providers accountable;
  • Focusing on outcomes rather than procedures; and
  • A new platform that provides for the full continuum of care, including post-hospital care.

It’s been said that the difference between an ordeal and adventure is attitude. Consider this as we enter the next
stage of health reform. I suggest we follow in the footsteps of Major Powell. By the time his journey was complete
in August 1869, he and the remaining five crew members had journeyed more than 900 miles to emerge at the
mouth of the Virgin River. The lessons learned through this expedition would challenge almost every previously
asserted fact about the West and shape the development of its future.

Like Major Powell, we have the opportunity to be trail blazers. Colorado has the framework to put a model health
care system in place and prove that it works. We are ahead of much of the country in terms of health information
technology, the All-Payer Claims Database, Connect for Health Colorado, a focus on population-based care and a
commitment to patient safety. These developments put us in the perfect position to be a pilot state for the next
wave of reform. It’s the next logical step and one that CHA looks forward to taking with all of you.