Moving the Needle in Transforming Our Healthcare System
Healthcare reform is a hot topic. And rightly so. If done right, it has the potential to truly transform our healthcare delivery system. Recently, Secretary of Health and Human Services Kathleen Sebelius, posted a piece on the Commonwealth Fund website which discussed the need to approach healthcare delivery in a coordinated and patient-centered way that focuses on keeping patients healthier.
Secretary Sebelius cites the statistic that two-thirds of Medicare spending goes toward beneficiaries with five or more chronic diseases. Yet under the current payment system, doctors are paid for quantity of individual services instead of for managing and coordinating the care of their patients across time and location. She writes, “Dysfunctional incentives create fragmentation and fail to address the underlying drivers of disease.” And there are ways to create open communication between patients and care managers to address the drivers of disease and keep patients healthier, all at significant cost savings to Medicare. We’ve seen it work.
Secretary Sebelius goes on to discuss how the Affordable Care Act creates incentives for the creation of “accountable care organizations” (ACO). This idea has become a very hot topic in the past few months and we applaud the efforts to encourage ACOs, which allow doctors to better coordinate patient care and improve the quality of that care. Disease prevention and the reduction of unnecessary hospitalizations are two of the main benefits of ACOs cited by the Secretary, in addition to the reduced costs to the healthcare system. By incentivizing ACOs to provide higher care at reduced costs, the Affordable Care Act returns some of those cost-savings to the ACOs.
Encouraging and incentivizing ACOs to improve healthcare delivery at a reduced cost would be a win-win for virtually everyone in the US healthcare system.
The Secretary notes “while Medicare will be leading the charge, we are looking for ways that Medicare can work closely with other public payers and the private sector.” Transforming healthcare in this country is the responsibility of all of us involved. We at Pharos have been doing our part by working in close partnership with payers and providers as well as taking part in several successful Medicare demonstrations to help improve healthcare delivery in this country.
“Our future must see a system that has the patient at the center, relies on teams of talented caregivers, provides financial rewards to those who improve care, and eliminates the inefficiencies that plague our current system,” Secretary Sebelius concludes. This is a great vision for the future; while we know this will be a journey, we welcome those who are ready to start that journey. We’ve worked with many organizations that not only have started the journey, but are making great strides toward a patient centered model that is marked by improved care at lower cost. Come join us!
