New Frontiers of Health: A Partners in Care Interview with C. Duane Dauner
“The baby boomers relied much more on traditional care. Whereas younger, emerging generations tend to rely less and less on the traditional care model—they go to walk-in clinics, use tele-medicine, search for care online, and are more likely to participate in wellness programs.”
Partners in Care Foundation presents its first Lifetime Achievement Award to C. Duane Dauner at the 19th Annual Vision & Excellence in Healthcare Leadership Tribute Dinner presented by Partners in Care Foundation on June 4, 2018 at the Beverly Hilton Hotel.
Duane has served as the President and CEO of the California Hospital Association since 1985, and recently retired. “I was surprised, honored and humbled by the fact that Partners is granting this award,” Mr. Dauner said.
Mr. Dauner has a legendary history working with and advocating for hospitals, medical community and policy makers.
“It all started in 1966 when I was an assistant professor at Washburn University in Topeka,” said Dauner. “I became employed by the Kansas Hospital Association from then until 1975 when I moved to the Missouri Hospital Association as President and CEO.”
In 1985 Mr. Dauner arrived at the California Hospital Association (CHA), serving in the same key leadership capacity.
“It was really through the arrangements of Carl Langley, CEO of Stormont Vail Hospital, who happened to be a Board of Regents member at Washburn University in Topeka. That was 52 years ago.” Today, Mr. Dauner serves as a special advisor to CHA where he manages ballot initiatives. His knowledge of the history of hospitals and funding deeply informs this work. To do this work, one needs to truly understand how hospitals operate and change. To manage this task, one needs to look at hospital history in the United States.
According to Mr. Dauner, “The first big impetus in changing hospitals occurred right after World War II with the passage of the Hill-Burton Act, which provided funding for several thousand hospitals around the country. The second big milestone was, of course, when Medicare and Medicaid were enacted in 1965. Since then several laws passed that have had significant impact on hospitals. The dependence on hospital inpatient services peaked in 1981.
Although the U.S. has a growing population of older adults, Mr. Dauner observes that the number of hospitals is decreasing, the number of hospital beds is dropping, and inpatient hospital utilization is shrinking, in part, due to new and emerging technologies, knowledge, techniques, and greater emphasis on wellness.
“The one thing most responsible for hospital changes are the technological and knowledge advancements—especially those since 1981,” says Dauner. “Future dependency on inpatient hospital care will continue but more and more procedures and care for patients will be rendered outside the hospitals in alternative ambulatory settings.”
Dauner went on to say that when looking at hospitals, one sees changes that are part of a continuum of health care. Hospitals are expanding to include the range from wellness and prevention to episodic care, post-acute care, rehabilitation, management of chronic conditions, management of behavioral health conditions, advanced illness and end of life care.
Dauner maintains, “One of the areas where there is extreme growth in the demand for health care is behavioral health. Those patients for the most part do not require inpatient hospitalization. In addition, innovative technology such as remote monitoring and time-controlled administration of drugs enable more and more people to be treated at home. It is a dramatic change in the way technology is deployed that reduces hospitalization and use of physician offices. Physicians are experiencing the same thing but not nearly to the degree that it is affecting hospitals. Today, people have many new settings to obtain care, such as clinics located in regional and nationwide retailers, stores, pharmacies, and at home.”
Mr. Dauner notes the difference in the way each generation interacts with healthcare.
“The baby boomers relied much more on traditional care. Whereas younger, emerging generations tend to rely less on the traditional care model and more on emerging technologies—they go to walk-in clinics, use tele-medicine, search for care online, and are more likely to participate in wellness programs,” stated Dauner.
What’s in our future?
Mr. Dauner notes that throughout this significant transformation, the one thing that is behind the curve is the payment system, particularly from government and private payers. He believes these will catch up during this profound transformation of where we get care, from whom, how it is delivered, and what it will cost.
“I see community-based organizations playing a greater and greater role because voluntarism and the need for community-based services to manage social determinants of health fit into today’s unique environment,” stated Dauner. “There’s simply less dependency on the inpatient bed setting and more emphasis on the community, home, and personal involvement side of things. That’s why I believe organizations like Partners in Care Foundation will be playing a vital role in the future.”
According to Mr. Dauner, our national culture was built on competition, choice, and freedom and that common thread will continue throughout society including health care. However, how we view freedom, choice and competition will evolve as the health care financing, payment and delivery systems continue to transform.
“People should have universal coverage and access to care. I believe the United States needs one uniform, nationwide benefit package,” said Mr. Dauner. “With a uniform benefit package everybody should have equal access to care when needed. This is what most other countries do. Everybody needs health care, but not everybody’s going to use every service.”
“If you look at the lifetime cycle in our society, more emphasis is being placed on prevention and living healthy. We’re gaining knowledge to understand better ways to support healthy living. And this is our future.”
For information on sponsorship opportunities and tickets to the 19th Annual Vision & Excellence in Health Care Leadership Tribute Dinner, please go to picf.org/tributedinnersponsorship, or contact Stephanie Wilson, Vice President, Development at Partners in Care Foundation, at firstname.lastname@example.org (818) 837-3775 x121