Everyone knows the cost and quality relation in healthcare: the lower the cost and the higher the quality, the higher the value. However, the obstacles in the US healthcare system have made it impossible to improve the value equation on a large scale. In spite of tens of thousands of hard-working, well-intentioned people in the industry, quality continues to be inconsistent, while costs continue to rise.
The progress towards value-based care is not easy; it requires new skill sets and policies. Healthcare organizations need to focus on how they can move beyond providing sick care to promoting the long term health of their patient-clients.
Outlined here are some suggestions to improve the healthcare system.
- Healthcare providers need to organize themselves around the needs of patients, instead of around what they do and how they are reimbursed. This entails a shift from individual discretionary services to detailed, patient-centered care of conditions in which an entire team organize themselves around the patient’s disease to provide comprehensive care across the range of the disease.
- Providers need transparent and easily available information on cost and quality to influence the value equation. Hospitalists need to collaborate with their systems to collect and report cost and quality metrics for their patients. Measurement and reporting of cost is imperative in impacting the value equation.
- Payment for services should reflect the actual cost of the service. Healthcare organizations need to start being comfortable with the idea of being held accountable for the cost and quality of certain patient types, including reducing unnecessary expenses and avoiding complications.
- Care should be incorporated into a smaller number of large delivery systems, instead of a large number of smaller systems. These large systems have to work for the welfare of the patients, integrating their care and not just duplicating services in each location. Integrated systems can direct the right patients to the right location, improving both cost and quality.
- Healthcare systems need to focus on patients on getting the right care in the right place. With the availability of low-cost travel options, this can and should be feasible for most patients and their families.
- Information technology systems need to be organized around patient-centered care. In the healthcare system of the future, the EHR has to be readily accessible to all healthcare providers, as well as to the patients themselves. Data should have common definitions and be easy to input and extract.
Although all these suggestions are appealing, accomplishing all of these quickly and at the same time will be extremely challenging. It will take great leadership and faith in the goal of achieving this high-value healthcare system.