AAMC Briefs Capitol Hill on Healthcare Innovation Zones

Academic medical center leaders held a briefing on Oct. 27, 2009, for congressional staff on Capitol Hill to discuss the transformative potential of Healthcare Innovation Zones (HIZs) as part of national health care reform.

The AAMC and the Congressional Academic Medicine Caucus (CAMC) co-hosted the session, "Accelerating Healthcare Delivery System Reform through Healthcare Innovation Zones." This was the first event for the caucus, a new, bipartisan group of congressional members dedicated to maintaining and strengthening the nation's medical schools and teaching hospitals.

Hosted by AAMC President and CEO Darrell G. Kirch, M.D., the briefing featured speakers Gordon Alexander, M.D., president of the University of Minnesota Medical Center, and Beth Felder, J.D., director of federal relations for Johns Hopkins Medicine.

HIZs, which are proposed as part of the Healthcare Innovation Zone Pilot Act of 2009 (H.R. 3664), would help to reduce costs and improve health outcomes by allowing multiple providers and payers to participate in one model of health care, bringing together more patients to establish health care solutions tailored to their communities, gathering statistically powerful data in order to demonstrate what does and does not work in each HIZ model, and removing the barriers that currently prohibit providers from working together.

"Most of what we as a nation have been thinking about is how to insure more people," said Kirch. "When we talk about reforming health care delivery, we sometimes seem to be hoping more than implementing. But we want to motivate those on the front lines to use the tools of innovation in a purposeful way. That's what healthcare innovation zones are all about."

The AAMC believes that as the nation moves to expand health care, it must also work to find delivery system innovations that work for local communities. While accountable care organizations (ACO), medical homes, and other innovative approaches to care take steps in the right direction, they are only components of what must be a full transformation of health care delivery.

Similar to ACOs, the HIZ concept would allow providers of all types to come together to establish "ground-up" solutions tailored to their communities—while creating shared savings for Medicare and providers. According to Kirch, the Healthcare Innovation Zone Pilot Act of 2009, sponsored by Rep. Allyson Schwartz (D-Pa.), has the potential to scale up delivery system innovations from small improvements to larger, more community-wide models. HIZs also would allow teaching hospitals, medical school faculty, and others to create a new culture of care through rapid redesign, combined revenue streams and more advanced delivery systems. The HIZ bill, introduced in late September, is currently not included in the House or Senate health care reform legislation.

Several academic medical centers are already testing new approaches to health care delivery. For instance, at the University of Minnesota Medical Center, part of Fairview Health Services, 12 "care packages" are being implemented that provide central treatment locations for patients with various chronic conditions, and help reduce health care costs.

"We need to fundamentally change payment structures, and find new solutions for care," said University of Minnesota Medical Center's Alexander. "In the olden days, it was all about costs, but now, it's also about innovation."

The HIZ proposal would allow institutions and providers to not only test and expand new care models, but also to track results and measure outcomes. According to Felder, current Hopkins innovations have improved health outcomes and reduced costs for approximately 160,000 Medicaid patients. HIZ participation, Felder said, could help Hopkins extend these innovations to cover more local patients, particularly those from underprivileged backgrounds.

"It would provide academic medical centers around the country with an opportunity to take what they know and design a system that works best for their community," said Felder. "We can then study and evaluate what we do and share that knowledge."