Essentia Health CEO Dr. David Herman addresses U.S. Senate Subcommittee

Essentia Health CEO Dr. David Herman was invited to testify about the current landscape of rural health care to members of the United States Senate Committee on Finance on Wednesday afternoon in Washington, D.C.

Dr. Herman highlighted Essentia's leadership in providing value-based care to the patients we are privileged to serve, resulting in better patient outcomes and lower costs. The hearing, hosted by the Subcommittee on Health Care, was titled “Improving Health Care Access in Rural Communities: Obstacles and Opportunities.” A recording of the hearing can be viewed here.

Value-based care focuses on improving overall patient health with an emphasis on wellness and prevention. This approach allows us to partner with patients to provide the right care at the right time. For example, by better managing chronic conditions such as diabetes and congestive heart failure, we can help patients avoid emergency department visits and hospitalizations. Thanks to an integrated health system and robust electronic health record, we offer coordinated care throughout a patient’s journey.

We also work with our patients to screen for social needs that impact their health. By identifying patients with food insecurity, transportation or financial challenges, we can connect them to community resources. This helps patients access healthy food, get to appointments and follow their medication and care plans.

Along with improving health outcomes and the quality of care, value-based care lowers health care costs. Essentia participates in 23 value-based programs with both government and commercial payers with more than 200,000 attributed members. From 2018 to 2021, we have removed more than $100 million from the cost of care through these value-based programs, while meeting high quality standards.

“At Essentia, we work tirelessly to improve health care in rural communities,” Dr. Herman said. “This includes a commitment to value-based care because of the better health outcomes and greater affordability demonstrated by this model. We are proud to be recognized as a leader in rural health care and excited to continue to put the health of our patients at the heart of all we do.”

In addition to value-based care, Dr. Herman touched on a variety of other topics while answering senators’ questions, including:

• In response to a question from Senator Benjamin L. Cardin (D-Maryland) about specific programs that preserve access to health care in rural communities, Dr. Herman highlighted the benefit of bringing care to the patient whenever possible: “When you think about the economic costs that some of my colleagues have mentioned, about having your son or your daughter take a day off work to drive you from Ely, Minnesota, to Duluth, Minnesota, for a 20-minute visit and then drive back, that could be better served by a community paramedic, is certainly a challenge for the family and a waste of America’s economic vitality. So funding those programs where we can actually go to patients, whether it’s through telehealth or through the community paramedic program, can make a huge difference.”
• Asked to describe what a successful value-based care program looks like, Dr. Herman responded: “It takes really three things: to know who your patients are, you know what they need and that you can get it to them before they really need it. That promotes health, wellness and well-being, and it also decreases the cost of care.” That prompted the following reply from Senator Sheldon Whitehouse (D-Rhode Island): “I would love to work with you going forward. So let’s stay on this.”
• Sen. Cardin offered the following observation: “I really congratulate each of you for innovative ways to deal with rural health care in your service areas. … It’s encouraging to see what you are able to provide for your communities. I congratulate each one of you for your commitment to the health care of your communities.”
• On workforce challenges, Dr. Herman said: “It will require a lot of innovations for us to not only treat people more efficiently and more effectively, but find ways to keep people well to reduce the burden on the health care system and more (importantly) to reduce their burden of illness.”
• Senator Steve Daines (R-Montana) noted that Essentia has “had some of the most successes in Minnesota (regarding value-based care), but there are others that I know are interested in adopting similar approaches, as well.”
• Dr. Herman discussed treating patients more holistically and involving community support: “If you’re living in a food desert and people are eating high-salt foods, the chances of them being hospitalized for congestive heart failure is very, very high. So rather than just taking a look at the patient’s path from illness to wellness, what’s the patient’s path to sustain themselves after they get that? And that’s building the community.”
• On the number of rural hospitals that have closed and how best to support small-town hospitals, Dr. Herman discussed the value of an integrated health system. He said: “We believe that no rural hospital should have to stand by itself. And I think many of the ones that are closing are hospitals that have had to stand by themselves. So we have hospitals within our system that if they were not part of a system, they would not be able to stand by themselves.”
• Asked about the accountable care organization (ACO) model, Dr. Herman responded: “We are strong proponents and strong practitioners of value-based care in the ACO model. … We believe it’s the best way to care for patients.”