Some of our colleagues and many citizens believe health care reform is going away with a potential change of the President, but they are incorrect for 2 reasons:
1. Private business and managed care companies cannot support our expensive illness care system any longer, and they expect that we reform our models of care
2. The current reform processes started in 2009, and each year has requirements that are being implemented (Figure 1).
We must lead our staff and physicians to redesign our care models. How we do our work and fully integrate the concepts of health reform into our new model of care is the opportunity we must cease.
The major concepts of a reformed system of care are as follows:
1. Moving from volume to value
2. Health not illness system
3. Health home concept (medical home, as some call it)
4. Care coordination across the continuum
5. Health care user or person centered care
This new world order is a challenging one for each of us because we actually have a foot in both worlds right now. We are being paid for our current model while transitioning to a future model (Figure 2).
I use a puzzle to help our leaders and staff understand the actions and changes we have been making and how they fit into our future model and the new world order.
I challenge each of you to clearly visualize this new "health centric" world. You must make massive changes to succeed, but they will be in increments as the puzzle depicts, and they must be in lock step with the elements and principles of the affordable care act. Are you ready to take bold steps to create new, totally different models of care? What tools are you developing to help your staff understand the journey our industry is taking? Do you really have a vision of what the future will be, and can you create it?
"Imagination is the beginning of creation. You imagine what you desire, you will what you imagine and at last you create what you will." George Bernard Shaw)
-Rhonda Anderson, DNSc(h), RN, FAAN,
FACHE
Guest Editor