While Kentucky's senior senator, Republican Floor Leader Mitch McConnell, is plotting to repeal health care reform, Kentucky's medical community is planning how to make it work.
About 480,000 Kentuckians who now have no health insurance would gain coverage under the Patient Protection and Affordable Care Act that Congress approved and President Barack Obama signed earlier this year.
How does Kentucky, a state already suffering from physician shortages, create the capacity to provide all that expanded care?
Training more health care professionals is one of the aims of a new alliance announced this week between the University of Kentucky's UK HealthCare in Lexington and Norton Healthcare in Louisville.
Also among the alliance's aims are improving the quality of care and reducing costs — goals that are consistent with the reform law.
Dr. Michael Karpf, UK's executive vice president for health affairs, says that, regardless of what happens politically, the reimbursement models that drive health care must and will change to "bend the cost curve."
Norton, a non-profit that runs five hospitals in Louisville, got a leg up on reducing costs when it was chosen for one of four pilot projects testing the concept of accountable care organizations. ACOs are aggressively promoted in the reform law; they are one of the ways Congress plans to keep Medicare on sound financial footing for the baby boomers and beyond.
The idea behind ACOs is to save money by aligning Medicare payments with the quality of care; taxpayers would reward care that keeps people healthy and produces good medical outcomes, rather than continuing to pay based on volume of procedures.
The Norton ACO is part of a joint initiative of the Brookings Institution and the Dartmouth Institute for Health Policy and Clinical Practice. While UK will benefit from Norton's early experience with ACOs, Norton stands to benefit from UK's expertise in high-end care and its experience educating health care professionals.
Reducing costly duplication is another of the alliance's goals.
This partnership is only in the early stages; the two institutions have just signed a memorandum of understanding. The exchange of ideas is just beginning.
The University of Louisville and its medical school are looking at a similar partnership with Catholic Health Initiatives.
The real test, of course, will be whether Kentucky (the whole state, not just the big cities) benefits from such collaborations and whether working together can provide something that's more akin to a system than the current approach that leaves so many without a medical home.
It's good to see Kentucky's health care leaders, especially its flagship university, working toward practical solutions — even if some elected leaders seem more interested in scoring political points.