By Harris Allen
In 2018, Site Selection magazine named Georgia the top state for business for the sixth year in a row. As before, however, the criteria used in the ranking did not include population health. That same year, America’s Health Rankings placed Georgia’s health in the bottom 20th percentile (39th), where it has been hovering for the last two decades.
Georgia’s poor health ranking is jeopardizing its business ranking. Not only do less healthy individuals perform more poorly at work, but less healthy workforces have been linked to worse financial performance in the business sector.
Consider 33rd-ranked North Carolina. With the merger of SunTrust Bank, which has been based in Georgia since the 1800s, and BB&T, the new combined bank will be headquartered in the Tar Heel State. North Carolina also has embarked on an aggressive new approach to improving health and health care. Georgia risks falling behind if it does not address its own health situation.
The “Health Act,” approved by the 2019 Georgia General Assembly and signed by Gov. Brian Kemp, has the potential to transform the status quo. Its stated primary purpose is to improve effectiveness and efficiency in health care. Yet it also includes guidelines for innovation, coordination, collaboration and measurement that can lead to improvement in health, productivity and business performance while reducing costs.
Under the legislation, the Office for Health Strategy and Coordination will be created. The director of the office will be appointed by the governor and will report to the governor. This office will be tasked with promoting innovation among providers and payers. Likely targets will include waste in health care expenditures and the problem of the underinsured.
Currently, as much as 30 percent of all medical spending is going toward unnecessary services and excessive administrative costs, while nearly a quarter of Americans are spending more than 10 percent of their annual income on health. These issues require new attention in Georgia.
But if the goal is to improve the health of the population, focusing on care alone will not be enough. A combination of other factors can have a cumulative impact on health outcomes that is four times the impact of actual health care. These include “risk behaviors” such as chronic physical inactivity, socioeconomic conditions such as poverty and physical environmental factors such as housing.
New coordination will be needed. The office will be working with state health agencies such as the Department of Community Health and the Department of Human Services to forge greater synchronization in their approaches to shared targets. This synchronization could prioritize risk behaviors.
New collaboration will also be needed. The office will be reaching out to non-health-oriented agencies like the Department of Transportation and the Department of Public Safety, whose actions can help improve Georgians’ health. One focus could be new ways these agencies can cooperate with health care personnel to attack health threats like food insecurity, interpersonal violence, housing instability and transportation access.
Another guideline calls for a new framework for analysis and reporting. The office will be compiling and forwarding to the governor annual reports from 13 health-oriented entities such as the Hemophilia Advisory Board. It will also convene a broad range of stakeholders, including plans, providers, state agencies and self-insured employers, to set up the Georgia Data Access Forum. The objective will be to develop a common data platform, which could be oriented to prioritize health improvement in public/private decision-making.
Including employers here might seem surprising to some. Yet leading self-insured employers have developed award-winning workplace wellness programs that have developed successful methods of measurement and management that improve health and productivity and reduce costs. These methods can be adapted as the office advances what, as envisioned here, needs to become the goal: a statewide culture of health.
This office will be working with the governor to bring together key stakeholders for the first time on a wide-ranging agenda with the capacity for quality improvement — prerequisites for the all-out effort required for the task at hand. Such an all-out effort could foster outcomes that all Georgians support: better life expectancy and health-related quality of life as well as better worker productivity and business performance, not to mention attracting new business and broadening the tax base. Hopefully, our state will fully embrace this opportunity.
Harris Allen, PhD, leads the Harris Allen Group, which he founded in 1998 to support the improvement of performance in health and health care. Clients have included employers, health plans, onsite clinics, and pharma. He has held posts at Rand, Aetna, New England Medical Center, and Coopers & Lybrand, and faculty positions at Yale, Thomas Jefferson and Brown Universities. Since 2015, when he returned to Georgia where he grew up, his work has been devoted to initiatives that advance value-driven population health. Allen served as an adviser to the development of the ”Health Act” legislation.