CHICAGO — Massive disruptions are ahead in health care, including blowing up the fee-for-service model and making care more affordable, Bernard Tyson, chairman and CEO of Oakland, Calif.-based Kaiser Permanente, told attendees at the American College of Healthcare Executives’ 2017 Congress on Healthcare Leadership on Tuesday.

Tyson challenged ACHE members to use their “firepower” to take health care to the next level and to invest in a system that provides something better than “episodic care after something has gone wrong.” This includes early diagnosis and treatment and helping patients with the behavior modification needed to manage chronic conditions.

“This is on our collective watch,” Tyson said. “We need to turn up the volume [about moving] from a sick-based system to a health-based system.”

Tyson noted that he was a supporter of the Affordable Care Act and was applauded when he said that it does not meet his definition of “disaster,” even though some politicians describe it as such.

Tyson told of how he met with President Donald Trump and said the president listened intently and asked “great” questions. Tyson didn’t dwell on the American Health Care Act, the GOP’s repeal-and-replace legislation, but told ACHE members that it was up to them to “pick up the pieces and move forward.”

“It looks like the Affordable Care Act will have another day,” Tyson said. “My hope is that, with whatever we come up with in Round 2, we don’t lose ground.”

He described the ACA as a “great step forward” in providing care to the working poor, and Tyson pledged to work toward further reducing health care disparities.

This means everyone having access to the health care system’s “front door,” Tyson said.

The future of health care also involves addressing the social determinants of health and recognizing that a person’s family history, personal behavior and where they live can have more influence on their well-being than anything that can be provided in a hospital or physician’s office, he added.

Tyson closed by recalling his own short hospitalization and how fortunate he was that he didn’t have to ask, “Am I going to be broke after this?”

Gina Calder, vice president of ambulatory services for Yale New Haven’s Bridgeport (Conn.) Hospital, said she was glad to hear Tyson speak to audience members about their collective responsibility to the country and their communities to provide care that is accessible to everyone.

“It doesn’t stop at our front door,” Calder said.

She also noted that value-based care “is here to stay.” In reference to Tyson’s comment about blowing up fee for service, Calder said, “I’m not sure that’s something we can avoid.”

Being reimbursed for outcomes allows organizations to invest in things like information-technology systems that provide data on what strategies produce the best outcomes, Calder said.