Harvard Business Review’s The Strategy That Will Fix Health Care is an article that discusses ways to fix healthcare worldwide. In the article, they talk about health care costs rising. Due to Medicare and Medicaid recipients increasing, and low reimbursement rates, private doctors are moving to salary-based jobs. In the article, providers could reduce costs if they got help improving patient care. This article discusses how to change the healthcare system to be patient-centered. Different strategies are shown in charts and graphs in the article. The article describes simple and complex ways to fix the healthcare system. I think it’s going to be tough to get change in the health care system from clinical staff and administrators. It also provided articles related to the strategy for fixing health care that you could read.
There’s a strategy for value transformation in the article. They had six value agendas. The first value is organized into integrated practice units (IPUs). In the second value, you measure outcomes and costs for every patient. The third value is bundling payments for care cycles. The fourth value is integrating care across facilities. The fifth value is to expand excellent services across the country. In the sixth value, we build an enabling IT platform. Putting these values into practice could make healthcare better. All staff will need to work together to implement this type of value.
I think the most interesting part of the article is bundling costs for patients. This article says that the procedure cost should include all postoperative care. Furthermore, the provider should be responsible for any infectious disease the patient gets. It might be an excellent idea to include the cost, but I don’t agree with making doctors responsible for everything. Patients don’t always follow doctors’ advice for a variety of reasons. I really enjoyed reading this article. Here’s a guide to making healthcare more affordable.
Lee, T. H., & Robert S. Kaplan and Michael E. Porter. (2015, September 14). The strategy that Will Fix Health Care. Harvard Business Review. Retrieved February 11, 2023, from https://hbr.org/2013/10/the-strategy-that-will-fix-health-care
This is an excellent article choice! I agree about the bundled payments for surgery. I am a surgical oncology nurse practitioner and we see our postop patients as many times as needed during their 90 day global period. We are seeing some changes in the length of that global period by CMS, like the recent change in hernia repair to global period of 3 days. This has allowed surgical providers to increase reimbursement for their postop care by charging for the postop visits. I am not sure what motivated this change but it is first time I have seen this type of change. I also agree about how physicians are shifting away from private practice to salary positions. By working for health systems instead of private practice, physicians do not have to worry about overhead costs like clinic space rental/ownership, staffing costs, billing/ reimbursement. I actually think eliminating private practices may help reduce costs as providers can share the infrastructure costs instead of carrying the full weight of it including how that cost is disseminated to patients/insurance companies.
This is a great specific example, Dr.Threatt, of what you outline as reasons physicians are giving up the private practice model. These CMS reimbursement changes are motivated by movement away from fee for service to bundled value payments and happen relatively frequently as CMS (Medicare and Medicaid) fine tune their reimbursement schema for a variety of procedures such as anterior hernia “mesh” repair.
I believe the task of keeping up with such coding, billing and reimbursement changes and also remain compliant with CMS rules is much more challenging for practitioners in private office settings compared to their hospital or physician practice brethren. After all, if you can opt instead to be employed by an enterprise that hires, trains and ensures maintenance of qualified coding and billing staff, that is one huge potential expense and headache you won’t have to deal with as a practitioner!
Good Morning Pamela,
I enjoyed reading your article. One part that really stuck out to me is that providers could be responsible for any infection/ or post op complications that the person can get. I think this is a very dangerous chance to take. Like you stated, the patient is not always responsible and agreeing to do the things that the doctor suggests. There is no way a doctors can be responsible for what the patient does outside of the facility. IF the doctors start being held accountable for this, I can see so many of them quitting. We are already in a staffing shortage, and if they feel like they are being blamed for what the patients do or don’t do, why would they continue to practice. Can you imagine a patient who went in for bariatric surgery, and the physicians says with 90 days you can’t eat this or that and do not drink soda. Then the patient goes home and eats whatever they want and gets sick and has complications within the window of surgery. How is that physicians to blame for that? That would be a very hard situation for doctors to be in.
-Holly
Hi Ms. Rosenberger,
A good reason therefore, for carefully documenting all aspects of care including discharge instructions for continuing care at home. This can include documenting what the patient should do to avoid a subsequent hospitalization , for example. A health care professional should not be held responsible for decisions taken by a non-compliant patient , especially if it is clear that s/he did not follow post discharge instructions.
PDB
Hi Pamela,
I also did my post about this same article and i was interested to see how our opinions on the matter are alike and different. The cost bundling section was also very interesting for me to read as well. The post care treatment and costs also had me looking at it a little differently as well. I agree that sometimes the patient doesn’t listen to doctors’ advice and will go and not listen to post operation instructions. The value agenda as a whole is a great idea and I think it brings up alt of interesting points that can be built upon moving forward int the health care industry.