Decade Old Concept Drives Dallas, Texas Health Care Reform...Maybe

While ObamaCare seeks a strategy for health care reform, Dallas is moving towards what I call a community integrated delivery system (CIDS) to curb inflation. A decade old concept based on Steven Covey’s maturity continuum, CIDS applies these characteristics to health care entities progressing from dependence (what you can do for me), to independence (what I can do for you) to interdependence (what we can do together). CIDS hypothesizes that a true paradigm shift in health care would occur when a coalition of physicians, community leaders, consumers, insurers, hospitals, etc., like Dallas is presently assembling, collaborate to evolve their role in the health care delivery system from dependency to interdependency.

Grand Junction, Colorado without a matrix like CIDS made news with the lowest cost per Medicare patient in the nation while achieving quality outcomes. The achievement reflected years of physicians, at the behest of a major health plan, reaching the independent stage by collaborating to manage patient outcomes. A CIDS model would have been more inclusive giving Grand Junction a greater opportunity to reaching the interdependent stage and the political power to address government’s perverse reimbursement system that underpays excellence and rewards failure.

In contrasts, McAllen, Texas the nation’s highest costs per Medicare patient in the third most expensive state represents the dependency stage. Its health care providers have been described as clueless in seeing the big picture, quick to blame forces around them, convinced they are providing necessary and essential care but the evidence says they pursue revenue “for me” and not excellence “for you.”

If the Dallas coalition lowers costs just 22%, it will equal the national average strengthening its role as a regional health care provider while cutting a major cost in their economy; a win/win for everyone. If they reach the interdependent stage, Dallas will be the nation's high value model for free market health care reform facilitated by the community not controlled by a central government entity.