The changes coming to American health care through the Patient Protection and Affordable Care Act and other forces—with a greater focus on preventive care—will require universities to rethink what they teach and how they interact with their communities, said several college and health-care experts who spoke on Sunday on a panel at the Association of Public and Land-Grant Universities’ meeting here.
The health-care system is “moving away from paying on a piecework basis” to paying for value, and that means “we need different skill sets” in the health-care work force, said Susan Dentzer, senior health-policy adviser to the Robert Wood Johnson Foundation. As the $2.8-trillion health-care economy evolves, there will be more jobs for people who will work in communities as health coaches and more need for other professionals who can work in teams of doctors, nurses, and social workers—and not necessarily in hospital settings.
As universities think about the new jobs coming to health care, “we have to stop talking about primary-care physicians and start talking about primary-care services,” said M. Roy Wilson, president of Wayne State University.
J. Nadine Gracia, deputy assistant secretary for minority health at the U.S. Department of Health and Human Services, reminded the audience of the nation’s existing racial and economic disparities in health-care access and of the coming demographic changes. Those forces underline the urgency for training professionals who can provide care that is “culturally and linguistically appropriate,” she said. Black infants are twice as likely to die as white infants, Ms. Gracia said, and black women are 10 percent less likely to receive a diagnosis of breast cancer but 40 percent more likely to die of it.
Ronald M. Berkman, president of Cleveland State University, said the changes in health care present “immense challenges for us in higher education” as well as some new opportunities to better engage with the public. The struggle about the Affordable Care Act is “not about the website,” said Mr. Berkman, referring to the problem-prone federal site where people can sign up for coverage. “It’s about equity.”
Meeting those challenges won’t be easy, he added. Training a new kind of health-care worker will require breaking down barriers and silos that now exist within universities between schools and disciplines, and outside the institutions at the accreditation level. “This is our opportunity to demonstrate that we can get ahead of that curve,” he said.
But before that happens, university leaders may need to have their own change of thinking, one president, Ronald T. Brown of the University of North Texas at Dallas, suggested. As he put it, speaking from the audience: “Most vice presidents for health affairs and deans of medical schools are boasting about their new hospitals and tertiary-care specialties, when health care is clearly going in another direction.”