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Four Lessons: Grand Junction Stands Out in the Healthcare Reform Debate

Janice Simmons, for HealthLeaders Media, August 17, 2009

This past Saturday, President Obama stopped in to talk about healthcare reform at a town meeting in Grand Junction, CO, a community of 120,000 people on the western slope of the Rocky Mountains, which is described as having "one of the lowest cost, highest quality healthcare systems in the country" in a new report.

"How are you going to save money in the healthcare system? You're doing it here in Grand Junction," Obama told the crowd. "You know that lowering costs is possible if you put into place smarter incentives; if you think about how to treat people and not just illnesses; [and] if you look at problems facing not just one hospital or physician, but many systemwide problems."

"That's what the medical community in this city did, and now you're getting better results while wasting less money," he added.

So what is so special about Grand Junction—and puts it on the opposite end of the scale occupied by McAllen, TX, which was cited earlier this year in a New Yorker article for practicing inefficient care?

Grand Junction does not have an integrated system, and most of its healthcare payers and providers are unaffiliated—just like the majority of the country, says the report published by the New America Foundation. However, this Colorado community boasts "consistently excellent patient outcomes at relatively low cost."

The Dartmouth Atlas of Health Care rates Grand Junction as having one of the "most efficient medical communities in the nation," according to the report. In 2006, average Medicare spending per capita was $5,900, about 30% lower than the national average of $8,300 and only a third that of high cost areas such as McAllen. Grand Junction also rated higher on measures of medical quality with low readmission rates to hospitals and among the lowest number of average days spent in the hospital by individuals at the end of their lives.

So what lessons does Grand Junction offer to the national reform debate? The report offers four examples:

Lesson #1: Vision and incentives are "essential to an operational sense of community," the report says. Grand Junction’s leaders view their own self interest—and the community’s interests—as congruent, and this fosters "a profound sense of community capable of withstanding the pressures of more than 30 years of health system and societal change."

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