Transforming Healthcare. Morey Menacker
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Transforming Healthcare
An Insider’s Look on Why and How
Morey Menacker
Copyright © 2022 by John Wiley & Sons, Inc. All rights reserved.
Published by John Wiley & Sons, Inc., Hoboken, New Jersey.
Published simultaneously in Canada.
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Foreword
I have had the past good fortune on several occasions of meeting certain persons for the first time, who, after hearing them speak cogently for only a few minutes, have become my instant and durable friends. One such colleague is Dr. Morey Menacker, former President and Chief Executive Officer of the highly successful New Jersey‐based Hackensack Alliance Accountable Care Organization, and well qualified author of this brave new book, Transforming Healthcare. Given his very extensive experience as a master geriatrician and seasoned senior healthcare executive, the best three words I can think of to describe Morey are as “The Doctor's Doctor”.
More than twenty years ago, the Institute of Medicine (now known as the National Academy of Medicine within the National Academy of Sciences) published an urgent “call to action” for the American Health System in its seminal Crossing the Quality Chasm. This consensus‐based work defined quality of healthcare through six very important aims: Care that is simultaneously Safe, Timely, Efficient, Effective, Equitable and Patient‐Centered. In this regard, Transforming Healthcare continues to fire on all of these cylinders as the vision of the future is presented.
One of these aims is “Efficiency”, which the IOM originally defined as “avoiding waste, including waste of equipment, supplies, ideas, and energy”. I emphasize this definition often when discussing the time‐honored topic of “Cost of Care”, because it helps gets at heart of the economic mindset that is necessary for realizing what's at stake throughout this book. Yet, today's determinations as to what constitutes optimally efficient healthcare depends on which lens the many diverse stakeholders among the US healthcare system use for their own internal deliberations. And, as Dr. Menacker rightly points out, major challenges to overcome this resultant inertia stand in the way to achieving timely consensus‐based solutions for improved health status, such as redirecting resources towards improved patient‐centered primordial prevention efforts and away from our traditional delivery of downstream “sickness treatment”. Yet, at the end of 2021, the market cap of the healthcare industry exceeds $5 Trillion and per capita healthcare costs total $4.5 Trillion. Unfortunately, the Cost Curve is bending in the wrong direction, i.e. concave up, not convex down.
An important and illustrative example to denote in the context of Transforming Healthcare is cardiovascular disease (CVD), which is the leading cause of death, not only in the US, but for the entire world. CVD (including acute myocardial infarction, heart failure and other patients with coronary atherosclerosis), when combined with stroke account for four of the top 10 expensive conditions treated annually in US hospitals. Most major local and regional US hospitals provide comprehensive acute care services to patients with major acute cardiovascular events (MACE), including well‐staffed medical and surgical intensive care units, sophisticated state‐of‐the art technologies and procedure rooms for acute high‐definition imaging and multimodal revascularization interventions, and specialist physicians, nurses, pharmacists and other healthcare professionals with advanced training credentials. Well paid and incentivized traditional health system service line senior executives skillfully juggle day‐to‐day operations, complex and interdependent supply chains, ever‐evolving information