High-Value Care

Several regions of the country deliver health care with superb outcomes that happen to cost well below the national norm. Among areas recently highlighted in the media are Grand Junction, Colo., Salt Lake City, Danville, Pa., Marshfield, Wis., and Northern California. These and other areas of the country are examples of what is working well in health care today, but they are at risk of being bankrupted by the current payment system which rewards those who utilize more resources but deliver care with equal or poorer outcomes.

Some common features exist among these groups that contribute to the high-value care they deliver. First, they have a philosophy of teamwork in which care provided to patients is coordinated across people, functions, activities, locations and time. Second, they have a culture of focusing on the patient, in which they tend to provide all the care that is necessary but only the care that is necessary, and include patients as full participants in health care decisions. Third, they have aligned incentives for pay and performance measurement so they are financially motivated to behave this way. Apart from the cultural and philosophical factors, infrastructure--information technology in particular--plays an important role in supporting the care delivery.

Long-term improvements to U.S. health care will require real reform which starts with paying for value. The current reimbursement system punishes those who help their patients achieve excellent outcomes while using fewer resources. Aligning incentives so that providers deliver better, safer, less wasteful care, and collaborate so that care is provided more efficiently will take a huge bite out of growing health care costs. In other words there needs to be a focus on defining, measuring, and paying for "value" as the only tactic that will "bend the curve" in U.S. health spending.

Making chinks in the status quo may satisfy a few groups in the near future, but without major (and admittedly painful) changes soon, the long term future of quality patient care is dubious at best.

By Jeffrey Korsmo  |  July 1, 2009; 5:36 PM ET  | Category:  Health Care Reform
Share This: Technorati | Del.icio.us | Digg | Facebook
Previous: Building on What Works | Next: Letting Patients Share in Treatment Decisions

The comments to this entry are closed.