South Carolina’s health care successes B y S andy M au
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| S o u t h C a r o l i n a B u s i n e ss
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ike its sister states across the Southeast, South Carolina lags near the back of the pack in terms of health outcomes for citizens. Poor access to appropriate care in rural communities, exacerbated by a large uninsured population that can’t afford to seek preventive care, poses significant challenges to lifting the state’s population health profile. But there have been some remarkable health successes. Within a year of launching an effort to boost early childhood immunization rates in the early 1990s, the state ranked first in the nation and maintains a top-tier position on this preventive health quality marker. More recent statistics for South Carolina’s children offer glimmers of hope for our future. According to a 2011 Commonwealth Fund report on children’s health indicators, South Carolina is in the top quartile for preventive dental care, referrals for special health care needs and for race, ethnicity and income equity. Across the state, the byword for positive change is collaboration. Health care leadership in South Carolina is learning to work across industry type and even with competitors to make measurable improvements in the way care is delivered. New models of care like the patient-centered medical home are beginning to gain traction, as are early efforts to pay providers for whole-person care rather than individual tests, visits and procedures. In fact, the Agency for Healthcare Research and Quality ranked the state in the top five in the nation for improvement across quality measures in 2010. “Although South Carolina has really poor population health outcomes, it actually has a health care system that is working very well,” said Anthony “Tony” Keck, director of South Carolina’s Department of Health and Human Services. “Health is different from availability of health care services. Ninety percent of health and wellbeing for individuals has to do with income, education, personal choices, genetics and the environment. Our most important task is to make health care more affordable while finding ways to contribute to the overall vision of helping people become more healthy and live healthy lives.” Keck is championing a systemic effort to move the state’s healthy birth outcomes statistics up from bottom tier status. Since Medicaid dollars pay for more than half of the state’s births, it is an area ripe for improvement in terms of both health and costs. Working from a model he put in place while in Louisiana