June Simmons
Chief Executive Officer
Partners in Care Foundation
“We saw that people came into the hospital who really should have never had to.” (1:36)
Hi, I’m June Simmons. I’m CEO of Partners in Care Foundation in Los Angeles, California. Partners in Care is a center of innovation. We work through collaboration. We build partnerships with health providers, health systems, health payers, to really try to address change in the way we deliver care in America, to improve quality of life and to reduce cost, or to use the dollars we have more effectively.
I started in health care, bringing social work to a private community hospital with a teaching program, and focusing on discharge planning and emotional and social support for patients and their families. And so we got to see everything that didn’t work in the system. We saw that people came into the hospital who really should have never had to, that somehow early intervention would have landed them in a different health status; and we were forced to place some of them in nursing homes due to reimbursement considerations and the lack of proper supports in the community. And we just got mad as hell and didn’t want to take it anymore. We saw just basic systems problems. We got the hospital to let us form some solutions to that. We created a program there, and then I got recruited by the Visiting Nurse [Association of Los Angeles], which was all about home care; and then I founded Partners in Care to carry forward their legacy and our new vision of a better future for health and health care.
“In America, you know, we have a model that doesn’t help you too much up front, but if you’re near death’s door, it’ll just spend anything.” (1:18)
We look at large populations where there is a high cost, a lot of suffering, and where we find a collaborative partner that we think can have a transformational result. One area that’s very large is the last year of life. That’s 25 percent of the Medicare budget. It’s many, many people, and so we’ve done a lot of work there. We began with Kaiser [Permanente] and spent a number of years working with them on home and community alternatives in the last year of life, with great result. There was much improvement in quality of life and provider satisfaction, and tremendous impact on cost structure — at least 30 percent reduction in cost of care over the last year of life with better quality. Kaiser adopted that actually as a new standard of care and is rolling it out nationwide, and now we’re taking that — we hope — to scale in other settings with other populations and other health care leaders.
In America, you know, we have a model that doesn’t help you too much up front, but if you’re near death’s door, it’ll just spend anything. We feel like that should be modified to spend more up front and then render more choice about what’s appropriate at the end.
“Someone has to be running first, fastest, and be trusted enough that the other horses will come.” (1:17)
There’s no point in making change if you’re going to just break a promise at the end. So that’s a standard we have; if it turns out the model isn’t sustainable, it’s not successful. You know, some people say that change takes 17 years — a really big change. So we’re well into this one. It’s not going to take 17 more years; it’s starting to crest. You can see the waves starting to form that we can ride to a new future, it seems to me. And the way that change occurs is through early adopters.
You have to be hooked on the vision and you have to feel that, “Well, we have to do this; this is where we have to go.” That’s what I think early adopters are. They’re just driving down the road because they know at the end is the rainbow, and they have their eye on it. A lot of people who are implementers, behind the early adopters, they do all that other work, and it’s harder for them because I can see the outcome, but they see what it’s going to take. So you need that combination to really drive change home and drill down so it will be solid and lasting; but we have to have the head horse, you know? Someone has to be running first, fastest and be trusted enough that the other horses will come, and I believe we have that now.
“The business case is able to be established; and as good as kindness and good purpose is, the business case is powerful.” (1:19)
I think people like me are just at solution, and what we look at is what to do about the obstacle in front of us, and have we made some progress, and what do we have to do to make more? So, even though money may move around a little bit, I really believe the players can mostly be whole and that the nation’s fate rests on this. You know, if you look at the GAO’s [General Accounting Office's] forecasts and what happens with the [baby] boomers coming, if we don’t make these changes, it’s so dangerous that I believe we will rise to this occasion, and that will allow us to do the right thing, even though we have a very complex infrastructure that has to somehow yield to change. But the business case is getting so clear, that’s what makes me hopeful. I think with computers, with the data systems, with the new sophisticated analytic techniques that exist, the business case is able to be established; and as good as kindness and good purpose are, the business case is powerful. That combination that this is a good and noble and right cause, combined with this is what it’s going to take to address a business case of health in America, that will take it over the top.
03/01/2008
