Individuals living in our community are suffering with chronic pain and substance use disorder. On December 1st in downtown Greenfield, I had the opportunity to experience our Opioid Task Force address these issues with legislators, representatives from MassHealth, DPH and the Massachusetts insurance industry. We know that health care in the U.S. is the most expensive in the world and Massachusetts is the most expensive state in the nation. Partners, the most expensive health care organization in Massachusetts, will soon be charged with insuring a majority of individuals in this county with their Medicaid Accountable Care Organization (ACO) beginning in March of 2018.

I do not mind spending my money on something that is expensive if it brings me value. I value my car that will soon reach 250,000 miles. It was relatively expensive to purchase but there were very few repairs along the way and it is still going strong after 10 years. I believe it was worth cost.

But what about the value of health care? We live in a place that has the most expensive health care in the universe but still don’t feel the value. We learned from the representative from the insurance industry that Physician Medical Directors lead all of our insurance plans and decide what is covered or not. We know that the medical model for health care delivery is changing from fee-for-service or transactional health care to a population health model where care is integrated, person-centered and more holistic. How do we make certain that this new model of health care delivery brings value to the consumer when value is potentially defined by each and every individual differently? If I am suffering with chronic pain or substance use disorder do I feel that the health care system is designed to help me address these issues? Do I value what is available?

AIM: Increase the value of health care for the individuals in our community.

Measure: Satisfaction survey, quality of life scale, pain scale, anxiety and/or depression scale, etc.

Ideas for change: Determining what we value is a process to be thoughtfully considered and can be done independently or with the support of someone we trust. Values are what we choose to focus on or personal choices we make based on what we believe to be most important to us. For example: trusted relationships, safety, an emergency plan, comfort, independence, family, friendship, creativity, thrill seeking, travel, peace, feeling healthy, quality of life, new learning, faith, freedom, and sustainability are all values that you may base your decisions on. What we eat for breakfast, the car we drive or the vacations we take are all decisions we make based on our values and what matters to us.

Health care brings value when health care decisions take into account our individual values, are person-centered and based on what matters to us.

Plan: Let’s survey what we value and what it would look like for our health care delivery model to be in alignment. We will send surveys by email, share the results electronically and brainstorm what it would take to experience value in health care.

To address chronic pain and substance use disorder, our community would benefit from operationalizing a method for determining what each individual values so a treatment plan can be person-centered. Authorizing treatments that are in alignment with what the person values will reduce waste and costs. It is what a health care system that delivers value feels like and one I wouldn’t mind spending my money on.