Why Physician Offices Shouldn’t be Bingo Parlors

A thought-provoking blog by Sachin H. Jain in Forbes online this week suggests that the maxim “All healthcare is local” will soon be replaced by “All healthcare is social.” It sounds good, right? Research clearly shows loneliness negatively impacts health. So, why not find ways to support people, especially seniors, in improving their health by connecting with others?

Here’s the dangerous jump. If loneliness harms health, then healthcare should treat loneliness. What happened to senior centers, park districts, houses of worship, libraries and coffee shops? If we turn core community functions over to healthcare, we risk a further escalation of the medical-industrial complex and the costs that come along with it. Perhaps worse, we risk starving the gathering places that support of all us – even the healthy – in connecting with our neighbors, learning from each other and building shared lives.

Jain gives the example of Miami-based Health Sun Health Plans, which was recently acquired by Anthem, Inc. Its members have access to clinics “where social interaction and events are the main event—and medical care takes place in the background.” Next door to the waiting rooms, seniors can play games and take classes. Sun Health believes the proximity helps patients connect with medical services, make appointments and better manage chronic conditions.

Why not put the “healthcare” in the community, rather than the community in the healthcare? Health plans or integrated systems should work together to embed community health workers and other support services in libraries and senior centers. Then, they should connect patients to those existing community assets.

Sun Health and other programs like it have the right goals: reduce loneliness, improve care for complex patients and in turn, lower costs.  However, the execution lacks an evolved understanding of patient-centered care.

Jain points out that as value-based payments gain popularity, so will these types of programs. Essentially, healthcare organizations will weave themselves more closely into the communities they serve, in part so they can more closely manage the lives of their members and patients. The problem is that if value-based payments simply expand vertical integration in healthcare, they will fail to fulfill their promise to move dollars out of healthcare and back into our communities.