Local health officials hope that by 2020 Northwest Indiana will be seen as a destination for quality care for those in the region and beyond. They intend to make this happen by expanding local medical training, bolstering trauma care and vigorously recruiting physicians and services to the area.
"We want to treat patients with the best quality care by the best physicians and residents in Indiana, and not have to go to Chicago to get treatment because we can get it right here," said Pat Bankston, associate dean of the medical school at Indiana University Northwest. "I'd like to see Northwest Indiana as the place to get the best quality care."
To that end, Bankston hopes the region has a full-time medical residency program up and running by 2020. He says such an initiative will help with doctor recruitment and up the overall quality of medicine in Northwest Indiana.
"The presence of residents has a stimulatory effect on the quality of care. Right out of medical school they're sharp in their knowledge of things," he said. "The faculty that will teach them will be good to start with and get better as they keep themselves prepared to teach."
Bankston is already working to form a consortium with local hospitals and community health centers to host 100 medical-school graduates training for careers in primary care, surgery and psychiatry.
He also believes an increase in the number of nurse practitioners and physician assistants in the area will help lessen the doctor shortage in the region, and hopes to see a more coordinated effort among medical stakeholders to improve the overall health of the region.
Local medical providers are also preparing for an industry-wide shift, already underway, from a fee-for-service model to a reimbursement system based more on quality and value.
"It's going to be better coordinated, less fragmented and enhance quality," said Lisa Hopp, interim dean of the nursing school at Purdue University Calumet. "The movement from fee-for-service to value-based payments has already begun. The shift from quantity to quality can only be good for patients, as they will receive higher quality care."
Hopp, who is also the director of the Indiana Center for Evidence Based Nursing Practice, hopes the region -- and country -- will be able to meet the Institute of Medicine's goal of having 90 percent of medical decisions be evidence-based by 2020.
In the future, Hopp believes there will also be more opportunities for local residents to age in place and that health data will be interconnected to the point where doctors can access your records no matter the facility.
For Beth Wrobel, CEO of HealthLinc, improving the health of the region means ensuring all infants and toddlers get their recommended immunizations and expectant mothers receive prenatal care throughout their entire pregnancy. That last one would help cut down on the infant mortality rate, Wrobel said, noting that only 45 percent of the moms HealthLinc serves sought care during their first trimester.
She said the "triple aim" for providers going forward is to have better outcomes, improve the patient experience and provide less costly care. She predicts an influx of more "patient navigators," who help with everything from scheduling follow-up appointments to making sure clients do their prescribed tests.
For its part, the Indiana State Department of Health has as its top five priorities to reduce infant mortality, obesity and smoking; prepare against infectious diseases; and enroll low-income Hoosiers in the new Healthy Indiana Plan, state Health Commissioner Jerome Adams said in a recent speech in East Chicago.
Robert Krumwied, president and CEO of Regional Mental Health Center, said he expects the new Healthy Indiana Plan, the governor's recent Medicaid expansion popularly known as HIP 2.0, to improve the health of the region by increasing access to low-income residents. He said HIP 2.0 increases Medicaid coverage to nearly 80 percent of Regional's patients from just 35 percent.
Krumwied also believes that over the next five years the mental health sector, which has suffered from a shortage of professionals, will begin attracting more providers as their pay comes in line with other areas of medicine and government-recruitment efforts bear fruit.
And he expects behavioral and physical health to continue to integrate, as providers work to meet all of a patients' health needs under the same roof.
"A lot of our client have pretty significant physical issues: diabetes, chronic obstructive pulmonary disease, asthma, diabetes, high blood pressure," he said. "Folks with chronic mental illness tend to die 20 years earlier than the rest of the population."
Several hospitals in the region are seeking designations as trauma centers so residents who are seriously injured won't need to be transported to the Chicago area. This is another way to stop the millions -- or perhaps billions -- of dollars that leave the region every year when residents travel across the border to Illinois for care.
And hospital systems, under increasing pressure to keep patients out of the hospital, continue to expand their outpatient offerings.
"Hospitals are absolutely the most expensive health care delivery system," said Steve Lunn, CEO of Porter Health Care System. "If we can do things on an outpatient basis and keep people out of the hospital, we can be better stewards of our resources."
Providers are also under pressure to reduce costs. And it may be working.
"All of us note that each year when it comes time to renew our health care coverage, the costs go up," said Gene Diamond, CEO for Franciscan Alliance's northern Indiana region. "Well, consumers are putting pressure on their employers, the employers are putting it in on their managed care companies, and the managed care companies are putting it on politicians. That will inexorably cause costs to moderate and make us find ways to deliver care more effectively and efficiently than we have been."
Diamond also believes telehealth will play a bigger role in medicine in the future, as consumers look to receive on-demand care through smartphones and other devices, though it may take regulatory changes for systems like Franciscan to be able to offer telehealth on a large scale. "It's going to require us to develop tools that health care disruptors are now using on us," he said.