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Introduction
Changing the clinical processes in a system operating at full capacity is like changing the engines of a plane in flight. In both cases, the task may be difficult, but it is necessary to move in the proper direction. Iowa providers want to move in the best direction, but they face a combination of issues that make responding to change even more challenging:
- Iowa has a geographically dispersed and aged population. It is often less efficient to practice medicine in areas where population density is lower. Moreover, solutions that work in urban areas may not work in rural care networks for multiple reasons. This poses a challenge to Iowa providers.
- Access to healthcare professionals is limited. Iowa ranks near the bottom nationally in the number of physicians per capita in most medical specialties. Many medical groups have been working to replace retired partners for years. Additionally, the numbers of other professionals, such as nurses and pharmacists, are also decreasing. Our delivery system will be severely challenged in the next decade as the supply of healthcare professionals declines.
- Provider reimbursement is limited. Reimbursement for medical services is among the lowest in the nation for both physicians and hospitals. This is actually the result of years of efficiency on the part of the Iowa healthcare system. Low reimbursement, however, limits our ability to change infrastructure or update physical plants. It challenges our ability to provide up-to-date, high quality care and our ability to meet Iowa's future healthcare needs.
Iowa providers are working to address these changes. The Iowa Healthcare Collaborative is a provider-led initiative that brings together providers, payers, purchasers, and consumers in a unique alliance. It is designed to achieve rapid cycle improvement in our Iowa healthcare arena. IHC participants believe we can reduce the cost of care delivery, raise the quality and safety of the care provided, and improve access to care for our patients. This unique structure has been called a model for other states to accelerate improvement in clinical performance and public health.
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