Public Health is on Life Support

Sarah Carroll, Director, Center for Care Transformation, AVIA


3 Things Healthcare Can Do to Prevent the Next Crisis

COVID-19 exposed massive faultlines in our nation’s public health infrastructure. Truth be told, my profession has been on life support for a while now. Since I entered the field in 1997, public health budgets have shrunk and we’ve lost over 60,000 jobs. While the United States spends a hefty $3.6 trillion annually on health, less than 3 percent of that spending is currently dedicated to public health and the art and science of prevention. 

It’s no wonder that healthcare teams feel like they’re moving from one crisis to another. Name the health risk, and I can almost guarantee that our rates are getting worse: preventable deaths from pregnancy and opioids; more Americans with untreated chronic conditions such as mental illness, obesity, and diabetes; wider disparities by race and socioeconomic status. The cost of kicking the can down the road is felt in lost lives and economic pain.

I have witnessed tremendous efforts by leading health systems in the AVIA Network to step up to these challenges. Here’s a snapshot of three things they’re doing, why they’re doing them, and what you can do to join us.

  1. Double down on chronic care. From behavioral health and substance use disorder to diabetes and hypertension, health systems in the AVIA Network are getting smart about delivering proactive, just-in-time care; implementing high-needs care models; and leveraging non-physician professionals to better engage and support patients. One digital solution alone is projected to save nearly $10M per year by empowering patients with real data and choices about their care plan. 
  2. Address social needs. The debate is over. Social determinants of health have an outsized impact on health system performance, and therefore require more attention. Across our Network, health systems are deploying digitally-enabled community health workers, navigating patients to high-quality community services, and providing housing, nutrition, and transportation support when local services fall short. These services help health systems lose less on uninsured or underinsured patients with complex needs. 
  3. Make a commitment to “be digital.” “Being digital” is different from “doing digital.” Doing digital is siloed and spartan. Being digital is strategic and spans across service lines. Being digital is not the work of the CIO alone. It is the work to bridge the minute-to-minute experiences of every frontline worker with the month-to-month support of every member of the C-suite. Being digital is more productive and has greater impact. 

Like public health, health systems will never get paid more for the work they are doing today. Like public health, health systems must transform their care delivery models and financing to provide more virtual, more personalized, and more continuous care to their communities with the same or fewer human capital costs.

AVIA’s Center for Care Transformation can help. We are a knowledge institute that researches effective models of care, deeply understands the solution landscape, and can recommend and guide digital execution to have a tangible impact on the total cost of care. Contact us at to learn more and join our Network.