A Momentous Day for Columbus, a Quiet Revolution for Health Care

It's not every day that a children's hospital has the President of the United States visit on the same afternoon as the Governor. But that's exactly what we got.
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It's not every day that a children's hospital has the President of the United States visit on the same afternoon as the Governor. But last Friday, Nationwide Children's Hospital welcomed President Barack Obama to Columbus, and then hosted Ohio Governor Ted Strickland in a separate ceremony an hour later. As CEO, I was privileged to be a part of both ceremonies.

What was most interesting about the two events is not what they said about the growth of Nationwide Children's Hospital, but about the newly evolving role that institutions like ours are playing in communities across America.

The President came to Columbus to confer the 10,000th transportation project awarded under the American Reinvestment and Recovery Act of 2009. It was for a road expansion project and urban rehabilitation plan that Nationwide Children's is spearheading in a neighborhood that borders our facility, in advance of our new pediatric hospital opening in 2012, which will be America's second-largest. Meanwhile, the Governor came to sign a landmark childhood obesity bill that state legislators recently passed, making Ohio the first state to respond to First Lady Michele Obama's challenge to end childhood obesity within a generation. Nationwide Children's was privileged to help lead a bipartisan coalition across the state to get it passed.

What made these two visits unique is that both were focused on work being performed by Nationwide Children's outside the four walls of our hospital, in support of our vision to create optimal health for every child in our community. Neighborhood revitalization and public policy leadership are not the kinds of projects for which hospitals have historically been recognized--but as America works to implement the landmark new health reform law, the role of hospitals is undergoing a quiet revolution in three primary ways that could transform our industry, our economy, and our country.

First, health care is driving U.S. jobs and growth. From 2001 to 2006, the U.S. economy added zero private sector jobs. By contrast, our health care economy added 1.7 million jobs. In many states like Ohio, which has seen the loss of hundreds of thousands of manufacturing jobs the past decade, lab coats are replacing hard hats as a symbol of jobs and growth. In Columbus, for example, Nationwide Children's is one of the fastest growing employers in the region. Our expansion and the project for which President Obama came to Columbus -which was conceived by our Board Chair, Abigail Wexner, after her visit to the Harlem Children's Zone--will add over 2,300 jobs. Of the 14.6 million jobs projected to be created from 2008 to 2018, the Bureau of Labor Statistics predicts that four million will come from health care and social assistance, with four of the ten fastest-growing careers in the health care sector.

Second, hospitals are taking more responsibility for improving public health. We are past the days when public health officials alone--the people responsible for making sure our water is safe, immunizations are available and trash is disposed of correctly--can handle the flood of public health challenges facing America today, from obesity to diabetes to low birthweights. Truly effective pediatric intervention, for instance, does not begin in the medical office or the public health department, but rather in the community--promoting the importance of regular checkups and immunizations; providing early and risk-stratified prenatal care for expectant mothers; educating children, teens, and parents about healthy lifestyles, and promoting public policy that supports good health. As Nationwide Children's exemplified in the campaign to pass the new Ohio obesity law, hospitals are often in the best position to engage every part of the community to improve public health. The Healthy Choices for Healthy Children Coalition we helped lead the past year was done so in partnership with the Ohio Business Roundtable and the Ohio Children's Hospital Association, together with partner organizations in business, healthcare, child advocacy, fitness and nutrition--the whole community coming together, Democrat and Republican, to make prevention a reality.

Third, pediatricians are uniquely poised to drive accountability in our system. Our new health reform law calls for the creation of "Accountable Care Organizations" to improve the delivery of health care. Pediatrics is a good place to start. By its nature, pediatric care begins as a community activity: from infant to toddler to school-aged child to teenager, an adult--either a parent or a guardian--is the person primarily responsible for managing the care of that child. We have seen the possibilities: through a unique arrangement with the state of Ohio, Nationwide Children's has operated as a pediatric ACO for the past five years. Each month, we receive a set payment for each of the 280,000 at-risk children on Medicaid across 37 counties, stretching from urban Columbus to rural Appalachia, and then manage their care. Since 2005, this partnership has dramatically reduced costs by improving immunization rates, reducing prematurity rates, decreasing readmission rates, improving safety, and vastly increasing access to pediatric care in some of the most economically underserved communities in America. It if can happen in central Ohio, it can happen anywhere.

The President and Governor helped recognize the early stages of a quiet revolution in health care. There's no telling where this could take us over the next decade.

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