NEVADA, Mo. (AP) — Polishing off his pork and beans at the local senior center, Gentry Malcom politely passes on the peas and broccoli still sitting on his plastic food tray. He's finished eating, but not done talking about how a heart attack nearly killed him a decade ago.
Malcom is still upset about a $1,600 co-payment — that took three years to pay off — for a life-saving helicopter ride from his rural hospital to a better-equipped facility in a bigger city. He's quit smoking. But his diet hasn't changed dramatically. Exercise? "I have an excellent muscle on my clicker finger for the TV control," quips Malcom, a 69-year-old diabetic who retired after a career at a state mental hospital.
His self-assessment: "Basically, I'm pretty healthy."
His lifestyle may suggest otherwise. Though Malcom may not realize it, he and the nearly 8,400 other residents of the western Missouri city of Nevada are about to become part of an experiment testing whether a rural community that ranks near the bottom of many health indices can be transformed into a national example where the people are healthier, their doctors are more efficient and their health-care costs are lower.
In short, it's a private-sector attempt at health reform — coming as a highly-charged national debate continues to rage over the pros and cons of the Patient Protection and Affordable Care Act of 2010 (PPACA), which seeks to expand health coverage to millions of Americans through insurance mandates and enlarged government programs.
"That's great there's a health care reform bill, but really this battle has got to be fought in a local ZIP code on the ground, and sponsored by leaders locally," said Jeff Townsend, executive vice president and chief of staff at Cerner Corp., a Kansas City-based health technology firm that is spearheading the effort in Nevada.
The Healthy Nevada project will equip the local hospital with a new $10 million electronic health records system and allow patient information to be more easily shared among the town's two dozen doctors and with medical experts in bigger cities. The city of Nevada, which recently enacted a special sales tax for parks and recreation, plans to chip in with new infrastructure such as bike lanes and improved sidewalks intended to make exercise more appealing. And an educational campaign will target residents with wellness screenings, nutrition tips and friendly competitions featuring prizes for such things as the top walkers or weight-losers.
The project seeks to improve both the health of individuals and the quality of care they receive while reducing the overall amount spent on health care.
The goal is "to develop a program that's never been done before," said Carol Branham, the executive director of the Nevada Housing Authority and one of several residents on the project's coordinating committee. "We want to be that model for the rest of the United States."
Other communities already have tried certain aspects of the plan. The federal government, for example, has awarded $250 million to 17 so-called Beacon Communities that already have made progress on developing electronic health systems that allow patient records to be shared among various medical providers.
The Beacon Communities program was funded by American Recovery and Reinvestment Act of 2009 (ARRA), a law containing health system change provisions that was enacted before PPACA.
