Kenneth E. Thorpe Ph.D. Of Emory University On 5 Things We Must Do To Improve the US Healthcare System

An Interview With Jake Frankel

Ensure that all patients have access to the benefits offered through health systems’ coordinated, value-based care. An integrative, person-focused healthcare model provided through a health system gives patients access to innovative care models that put prevention first. Minimizing a patients’ risk of developing chronic conditions should be a top priority, but if a patient has one or more chronic conditions, it is ideal if they can have them all treated under the same health system. We should make available and apply evidence-based treatment protocols to all patients with a specific condition regardless of race/ethnicity or source of health insurance.

As a part of our interview series called “5 Things We Must Do To Improve the US Healthcare System”, I had the pleasure to interview Kenneth Thorpe.

Kenneth E. Thorpe, Ph.D., is the Robert W. Woodruff Professor and Chair of the Department of Health Policy & Management, in the Rollins School of Public Health of Emory University, Atlanta, Georgia. He is also the chairman of the Partnership to Fight Chronic Disease, an international coalition of over 80 groups focused on highlighting the key role that chronic disease plays in the growth in healthcare spending, and the high rates of morbidity and mortality.

Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a story about what brought you to this specific career path?

I have always been interested in the nexus between policy and politics, which brought me to the largest, most complicated sector in the US economy — healthcare.

Can you share the most interesting story that happened to you since you began your career?

I think being designated by President Clinton to oversee the economic and financial analysis of his health reform proposal — the Health Security Act.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

I threw two dissertation topics in a hat — one on the economics of the entertainment industry (I was living in Santa Monica, CA) and the other on a healthcare topic. I picked the entertainment industry topic and wrote my dissertation on it. I quickly learned I was more interested in the politics and economics of the healthcare industry.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

Work with an enthusiasm unknown to man! Keeps me focused.

How would you define an “excellent healthcare provider”?

Great technical and people skills.

What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?

Love the journal Health Affairs.

Are you working on any exciting new projects now? How do you think that will help people?

I recently published a study on healthcare spending dynamics over the past decade using data spanning from 2010 to 2021. The data shows that the increasing prevalence and coexistence of chronic conditions in patients, such as asthma and diabetes, directly increases overall healthcare spending. As the U.S. population ages and chronic conditions become more common, policy regulations and health systems will need to embrace collaborative, innovative solutions to deliver continuous, high-quality care to patients.

Ok, thank you for that. Let’s now jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high-income nations. This seems shocking. Can you share with us a few reasons why you think the US is ranked so poorly?

In my opinion, the increasing prevalence and coexistence of chronic conditions in patients across the U.S. has contributed to this poor ranking, as have the skyrocketing national healthcare costs. These two factors have jeopardized the healthcare industry’s ability to effectively respond to public health crises.

Underlying this growth of chronic conditions is a growth of overweight and obese adults. Compared to our peers internationally, it is a shocking number. Compared to these peer nations, the United States under-invests in prevention and primary care. We are good at specialized services but do a poor job at public health preventions and primary healthcare. Chronically ill patients need to be able to manage their conditions through a combination of medication, primary care, and other specialized interventions.

As a “healthcare insider”, if you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

1 . Ensure that all patients have access to the benefits offered through health systems’ coordinated, value-based care. An integrative, person-focused healthcare model provided through a health system gives patients access to innovative care models that put prevention first. Minimizing a patients’ risk of developing chronic conditions should be a top priority, but if a patient has one or more chronic conditions, it is ideal if they can have them all treated under the same health system. We should make available and apply evidence-based treatment protocols to all patients with a specific condition regardless of race/ethnicity or source of health insurance.

2 . Look for creative solutions to reduce barriers to receiving high-quality healthcare where possible, with an emphasis on challenges facing our racial and ethnic minority communities. The data shows that Black and Hispanic adults have higher levels of chronic conditions, which may partly be driven by difficulties in accessing and receiving quality healthcare. Some of the differences are lifestyle related, but others are based on underlying patient genetics and characteristics.

3 . Minorities have higher rates of uninsurance, resulting in lower rates of utilization overall and less preventive care. We need efforts to continue to expand Medicaid at the state level and private health insurance at the federal level through expansions of the Affordable Care Act.

4 . Better understanding and reforms to address rural health concerns is also critical. Lessons learned from COVID-19 really highlighted the challenges of rural health across our country and while many legislators have long been beating this drum, there are some really clear opportunities for improving access and quality of care in rural areas.

5 . Coverage of obesity medicines! We’re seeing it in news outlets across the country and I firmly believe that addressing obesity is a mission critical component of fighting chronic disease and lowering overall health care costs.

What concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

Need to continue through federal and state policies to expand Medicaid and private insurance through expanded subsidies offered through the Affordable Care Act.

The COVID-19 pandemic has put intense pressure on the American healthcare system, leaving some hospital systems at a complete loss as to how to handle this crisis. Can you share with us examples of where we’ve seen the U.S. healthcare system struggle? How do you think we can correct these issues moving forward?

One of the things that happened during COVID-19 is the expansion of remote patient monitoring and other healthcare at home initiatives. We have devices that can monitor 14 different vitals at one time from the home, even a stethoscope that can listen to the heart, lungs and stomach. The technology evolved during the pandemic, and we need to continue that positive momentum. We are seeing that patients want to be treated at home and we need to ensure that we keep reimbursement in place for that to continue to happen.

How do you think we can address the problem of physician shortages?

This is another example of the benefit of remote patient monitoring. You can have one nurse practitioner monitoring thousands of patients at home time with the assistance of alerts. This can significantly help the staffing ratio. Right now, in-person, you may have one nurse for a handful of patients when this same nurse could be supporting with thousands of patients’ care remotely.

This approach also saves money. The extent to which we can now intervene with the support of remote care before problems present themselves is incredible.

How do you think we can address the issue of physician and nurse burnout?

I see this as another benefit of the virtual patient monitoring. Resolving the staffing issues is a major step in terms of lowering the rate of burnout for both physicians and nurses.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

I would provide federal funding for section 3502 of the Affordable Care Act and make community health teams. These teams focus on primary prevention and care coordination could be used by all payers and primary care practices to engage patients to prevent and manage chronic disease.

How can our readers further follow your work online?

I am on Twitter at @KennethThorpe.

Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.