Washington, DC – A panel of university presidents and health care leaders urged public universities to consider the impact of national health care reform on their institutions in a session of the Association of Public and Land-grant Universities (APLU) Annual Meeting on Sunday, November 10. The Affordable Care Act (ACA) and other upcoming changes will affect how universities educate future health care professionals and contribute to the health of their communities.
Susan Dentzer, senior health policy adviser to the Robert Wood Johnson Foundation, set the tone for the discussion by describing the current state of health care in America. “We need three things,” said Dentzer, “better health, better health care, and we need it all to cost less.” Although no one law will serve as a panacea, the ACA aims to help the United States make progress toward these goals by emphasizing preventive care, community and population health, and payment for value, not volume.
As a result of these national reforms, health care services are moving out of the hospital and into the community, where care is increasingly delivered by interdisciplinary teams. Universities must adapt their curriculum so that students will have the opportunity to train together in the same environment where they will apply their skills. In the health care system of the future, new types of professionals such as community health workers and health coaches will collaborate with physicians to provide care and engage the community. “We have to stop talking about primary care physicians and start talking about primary care services,” said President M. Roy Wilson of Wayne State University.
Ronald M. Berkman, president of Cleveland State University, suggested that “the ACA is as much of a paradigm change for higher education as it is for health care.” Initiatives such as Urban Universities for HEALTH will provide universities with the opportunity to “beta-test” new innovations with communities and demonstrate through data that those interventions have been effective.
In addition to preparing students for new roles and environments, universities must also consider how they will train students to provide better quality care that will alleviate persistent health disparities. J. Nadine Gracia, deputy assistant secretary for minority health at the U.S. Department of Health and Human Services, cited statistics demonstrating that ethnic minorities consistently receive lower quality care. “Quality care is culturally and linguistically appropriate care,” said Gracia. By eliminating these disparities, the nation would “reduce its health care expenditures by $229 billion per year.”
However, the panelists acknowledged that many universities have not yet taken sufficient action in response to the larger transformation of health care. Barriers and silos reinforced by existing accreditation systems must be broken down in order for health education to evolve. Many university leaders are focused on expanding their academic medical centers and training more specialties, rather than pumping money into primary care programs. “You need to have university leadership on board,” said Berkman. “The CSU/NEOMED partnership and its explicit focus on primary care is a good example.”
About Urban Universities for HEALTH
Urban Universities for HEALTH (Health Equity through Alignment, Leadership and Transformation of the Health Workforce) is a partnership effort of the Coalition of Urban Serving Universities (USU)/Association of Public and Land-grant Universities (APLU) and the Association of American Medical Colleges (AAMC) and the NIH National Institute on Minority Health and Health Disparities (NIMHD). The project aims to address the severe shortage of qualified health professionals in underserved areas by leveraging the power of urban universities to enhance and expand a culturally sensitive, diverse, and prepared health workforce.