Michael Bryant says "the train has left the station" regarding healthcare payment reform.

"People ask me what will happen if the Republicans repeal healthcare reform," The President and CEO of Methodist Health Services Cooperation said at the Heartland Healthcare Coalition (HHC) conference. "I say that it is irrelevant what happens in Washington."

Methodist is working with Caterpillar, Inc., to have an Accountable Care Organization (ACO) model available for employees by 2013. Methodist is also piloting two medical home programs.

The train, indeed, has left the station.

Bryant was one of four speakers at the HHC's 10th annual conference, "Accountable Care Organizations, Medical Homes, and Connectivity: The New Foundation for Health Care Services?" at the Embassy Suites Hotel and Conference Center in East Peoria on April 29.

Given the status quo, it's no wonder America is searching for something different. America spends twice as much on healthcare than any other nation, yet, America ranks 37th on the World Health Organization report card.

"We rank below Slovenia in healthcare outcomes," Jerry Reeves, MD said, of HealthInsight Nevada. "And we spend a lot more."

Americans only get the correct care about 50 percent of the time, according to a RAND Corporation study. And the Institute of Medicine estimates about 100 thousand deaths occur each year due to medical errors.

"We need a new culture, as good as it is," Bryant said.

Fixing a broken system

Experts are targeting the fee for service model, which pays providers for doing instead of getting good patient outcomes. This leads to what Marjie Grazi Harbrecht, MD, of Colorado Clinical Guidelines Collaborative, calls "treadmill medicine" where providers are constantly moving, seeing as many patients as possible.

Recent reforms are redesigning how care is delivered and paid for. The patient-centered medical home (PCMH) model may be the first building block. PCMH stresses primary care and collaboration between all who take responsibility for the care of a patient ? who is always at the center of the partnerships. The cornerstone of the PCMH is increased collaboration achieved through the use of electronic health records.

"It's the quarterback of care. When I throw my football out to the specialist, they are going to throw it back," Harbrecht said. "Communication used to happen. That stopped along the way and everyone got on their treadmills."

Patricia Barrett, MHSA of The National Committee for Quality Assurance, said the medical home pilots she has been involved with have experienced improved individualized care. Patients saw improvements even without realizing they were in a PCMH.

"They felt they were known," she said.

ACOs are the natural progression from the medical home. ACOs are a collection of providers responsible for the care of a patient where payment is linked to quality improvement that reduces cost.

Barrett likened ACOs to a "mythical creature no one has ever seen."

"We are trying to figure out, what is this mythical creature – feeling around for basic structure and key concepts," Barrett said. "Everybody could see what they wanted to see. Employers see it as saving money, patients see more personalized care."

It takes a region

Revamping the healthcare system is a monumental task that takes support from all stakeholders. As Harbrecht puts it: "It takes a region."

As the buyers of healthcare in America, employers need to be engaged to demand better services. Reeves spoke to the human resource professionals in the audience on how to get the CEO to pay attention. He uses the Supply Chain Management model.

"CEOs understand supply chain management. This is talking their language," he said. "If your CEO is not paying attention to this supply chain, shame on him, because this one is bigger than most of the others he is thinking about."

At the center of everything is the patient. The patient needs to be engaged before healthcare can be improved, according to Reeves.

"The doctor can prescribe Mrs. Jones a blue pill. Mrs. Jones has to swallow that pill," he said.

The transition will put the biggest burden on the providers, who will be at the center of the makeover.

"You're driving 100 mph, seeing patients because you're still on fee for service, and then having to change a flat tire," Harbrecht said.

Changing that flat tire will be difficult for the providers, but, according to Bryant, it is a "noble goal worth fighting for."

"The next five years in healthcare are probably going to be the most exiting in the last 50," he said, adding that providers are given a special moment to improve healthcare for future generations.