By Tyler Weingart and Kathy Orellana

Under our current health care system, we wait until young people with severe mental illness are very sick before treating them. Sparked by the tragedies of Newtown and elsewhere, mental health advocates and policymakers have a renewed sense of urgency to repair the broken mental health system so those with severe mental illness can get the help they need as early as possible. The Early Detection and Intervention for the Prevention of Psychosis Program (EDIPPP) –a grantee of the Robert Wood Johnson Foundation’s Vulnerable Populations Portfolio supported by Burness Communications – is a promising approach to treat mental illness at its earliest stages.  Launched in 2006 with support from the Foundation, EDIPPP has been collecting evidence from six diverse sites around the country on the effects of its early identification and treatment model, which focuses heavily on proactive outreach from people in the community.

 The goal of the model, which is based on a program started at Maine Medical Center, is to educate families and individuals who routinely interact with at-risk youth (teachers, coaches, members of the clergy, school nurses) about the key signs to look for in young people, to help identify and prevent psychosis before it starts. The logic of the model is simple: detect and treat a mental illness before it is too late.

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Note:  Linda Loranger, Senior Vice President and Director, Health Policy Team, leads our oral health work here at Burness Communications.  This piece highlights serious oral health access issues in the state of Washington, but it is an issue that affects the entire country.  Close to 50 million people live in areas where they can’t get dental care and millions more cannot afford it. 

Last month, a prominent annual assessment of health showed just how starkly different life can be county to county, state to state.  It demonstrated that your ZIP code can dictate how long and how well you live. But it also shattered the argument that a dental shortage doesn’t exist.

For the first time ever, the assessment, known as the County Health Rankings and produced annually by the University of Wisconsin Population Health Institute, and the Robert Wood Johnson Foundation (a Burness client), included access to dental care as one of the key measures affecting health in a county.  Oral health is critical to overall health yet thousands of people can’t get it.  The Rankings show just how dramatic the disparities are when it comes to getting dental care.

In Washington state, in Skamania County, the ratio of Washington residents to dentists is 11,122 to 1.  Across the state, in Whitman County, it is 3,626 to 1.  For the lucky residents of King County, the ratio is 1,063 residents to every dentist.  

Keep in mind that the Rankings, which are nationwide, assess the national benchmark at a ratio of 1,500 patients to one dentist.  In other words, if all counties were to strive for a healthy ratio of dentists, this is the goal.  Skamania County has a long way to go.

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We’ve all heard about the problem of rising health care costs.  The United States spends nearly three trillion dollars a year on health care – far more than any other developed country – yet lags on many measures of health outcomes and quality. As a proportion of the federal budget, the cost of Medicare has risen from 3.5 percent in 1975 to more than 15 percent in 2010. By 2020, Medicare is projected to consume 17 percent of the U.S. budget. So what can be done about it?

According to a report from the National Commission on Physician Payment Reform, a Burness client, changing the way doctors get paid is the first step to fixing our health care system. The report, released on March 4^th, details 12 sweeping recommendations aimed at reining in health spending and improving quality of care. Among them, the Commission urges lawmakers, health providers and insurers to move away from a fee-for-service payment system to a blended payment model within five years.

The 14-member Commission was formed by the Society of General Internal Medicine and is led by former Senator Majority leader Bill Frist, M.D., and former Robert Wood Johnson Foundation president Steven Schroeder, M.D.  In a joint Politico op-ed, Frist and Schroeder explain why fee-for-service is so problematic: “We pay physicians according to the number of services they provide. The skewed financial incentives inherent in a fee-for-service model promote fragmented care and encourage doctors to provide more — and more costly — care, regardless as to whether those services improve the health of patients.”

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On February 19, 2013, Andy Burness offered the following words at the Samuel Dubois Cook Society Awards Dinner in Durham, N.C. Dr. Cook, a close personal friend of Dr. Martin Luther King’s, was the first African American professor at Duke University and has the distinction of being the first African American to hold a tenured faculty appointment at any predominantly white college or university in the South. He has also had a tremendous impact on Andy’s life as a professor, mentor, and friend.

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