Did the Patient Protection and Affordable Care Act Kill the Hospital Preparedness Program? | Part 1 of 2

Did the Patient Protection and Affordable Care Act Kill the Hospital Preparedness Program? | Part 1 of 2

In January of 2012, the U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Preparedness and Response (ASPR) published the Healthcare Preparedness Capabilities, National Guidance for Healthcare System Preparedness (HPP Capabilities). Across the nation, hospital associations and regional coordinators from the major medical centers yawned and hit the snooze button. When they woke up this fall, the National Healthcare Preparedness Program (NHPP) had overshadowed their beloved Hospital Preparedness Program (HPP).

Of the five stages of grieving, most regional disaster coordinators are stuck between denial and anger with little hope of bargaining or depression, much less, acceptance before the end of the grant year on June 30, 2014. The eleven coordinators in Illinois have broken into two camps, the NHPP Resistance Army and the Cautiously Optimistic Progressive Party. The Progressive Party has chosen to make lemonade out of lemons, seeing the bigger picture - the greater societal good. The Resistance Army, on the other hand, is plotting to stop the Illinois Department of Public Health's (IDPH), less than ideal, implementation of the NHPP. The ferocity of the debate and sinister nature of the plans feels like the battle over the Patient Protection and Affordable Care Act (ACA). Change can be good, but forward momentum does not take hold until the grieving process is done. As stated by Jack Welch, the former CEO of General Electric and now celebrated author on change management "face reality as it is, not as it was or as you wish it to be."

So you say, OK Einstein, good rant, but how did the ACA kill HPP? We'll get there. When you pull back the curtain on the ACA and, the NHPP you will see a similar theology. No, we are not talking about the individual mandate, the percentage of the gross domestic product (GDP) that is spent on healthcare in the United States, or the insurance reform side of the equation. What is being lost in the press clippings and political banter is that the ACA has two legs, insurance reform and healthcare system reform. That is an important distinction, healthcare system reform - not hospital system reform?

So what is driving healthcare system reform and what does it have to do with the shift from HPP to NHPP? We'll get to the death of HPP later. In the simplest of terms, healthcare system reform is being driven by a lack of efficiency and effectiveness, which is on a collision course with the baby boomers, who are entering their golden years. Taken out of formal context, despite spending approximately 17.5% of GDP on healthcare, more per capita than any country in the world, the United States has one of the worlds most unhealthy populations.

Why is this? We have a disease management system, not a healthcare system. Disease management is very expensive, because the underlying assumption is that every citizen, insured or not, is healthy until they are sick. When people are sick, and I am not talking about the common cold or a few loose stools, they need very expensive medications, tests, and procedures - and too often treatment in an emergency room and admittance to the hospital. You see, our healthcare system is built on a reactive model. When someone gets sick, we respond. It is similar to disasters - when they happen, we respond. Response is very expensive and comes with great risks.

Maybe you see the analogy, but you still want to know who killed HPP. We'll get there. Managing diseases and responding to disasters are both the worst case scenario. To the contrary, managing health reduces the likelihood, severity, and cost of treating diseases, much like managing disaster prevention, preparedness, mitigation, and recovery programs reduce the likelihood, severity, and cost of disasters. Essentially, the move to managing health vs. diseases under the ACA might be seen as synonymous with the Federal Emergency Management Agency's (FEMA) emphasis on prevention, mitigation, preparedness, and recovery. And both are being driven by the same forces, efficiency and effectiveness.

So you say, Dude! What about the death of HPP and the birth of the NHPP? We'll get there, Dude! Look for part two in the October 10th connect eight!

Shine On - and keep doing good for the greater good!



Karl Schmitt, MPA

Karl Schmitt, MPA

Karl is the Passionate Founder & CEO of bParati. He is on a mission to build a national network of effective, sustainable healthcare coalitions. More...

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Karl Schmitt, Passionate Founder & CEO, bParati

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