Micheal E. Porter and Thomas H. Lee have an interesting perspective on the strategy that will fix the health care industry in their article “The Strategy That Will Fix Health Care”. They start by saying at the core of the strategy that it should be all about maximizing value for the patients. This means that they should strive to achieve the best outcomes at the lowest cost. Instead of focusing on what the physicians do, instead they should focus on what the patient needs. Porter and Thomas quote “And we must replace today’s fragmented system, in which every local provider offers a full range of services, with a system in which services for particular medical conditions are concentrated in health-delivery organizations and in the right locations to deliver high-value care.” (Porter & Lee, 2015).They also state that the transformation is not going to be an easy one. We need to restructure how health care delivery is organized, measured, and delivered. This is all detailed in what they call the “value agenda”. There are 5 different sections of the value agenda that need to be touched on. First, Organize into integrated practice units. They state that “The first principle in structuring any organization or business is to organize around the customer and the need. In health care, that requires a shift from today’s siloed organization by specialty department and discrete service to organizing around the patient’s medical condition. We call such a structure an integrated practice unit.” (Porter & Lee, 2015). The IPU takes all related problems from a single condition and work together towards a common goal: maximizing patients’ overall outcomes as efficiently as possible. Second, Measure outcomes and costs for every patient. “Teams improve and excel by tracking progress over time and comparing their performance to that of peers inside and outside their organization. Indeed, rigorous measurement of value (outcomes and costs) is perhaps the single most important step in improving health care.” (Porter & Lee, 2015). They also state that “Outcomes should be measured by medical condition (such as diabetes), not by specialty (podiatry) or intervention (eye examination). Outcomes should cover the full cycle of care for the condition and track the patient’s health status after care is completed.” (Porter & Lee, 2015). Third, move to bundled care for care cycles. It’s stated that “The payment approach best aligned with value is a bundled payment that covers the full care cycle for acute medical conditions, the overall care for chronic conditions for a defined period (usually a year), or primary and preventive care for a defined patient population (healthy children, for instance). Well-designed bundled payments directly encourage teamwork and high-value care. Payment is tied to overall care for a patient with a particular medical condition, aligning payment with what the team can control.” (Porter & Lee, 2015). The providers benefit when the efficiency of the care improves and when the outcomes improve because it is something that the health care team can control. Fourth, integrate care delivery systems. Porter and Lee say “To achieve true system integration, organizations must grapple with four related sets of choices: defining the scope of services, concentrating volume in fewer locations, choosing the right location for each service line, and integrating care for patients across locations.” (Porter & Lee, 2015). It is very hard to get everyone involved on board with moving locations or choosing the right locations for services. Being able to hit all four of those points will help health care systems to be able to accurately locate to maximize positive patient outcomes. Lastly, Expand geographic reach. It’s stated that “Health care delivery remains heavily local, and even academic medical centers primarily serve their immediate geographic areas. If value is to be substantially increased on a large scale, however, superior providers for medical conditions need to serve far more patients and extend their reach through the strategic expansion of excellent IPUs.” (Porter & Lee, 2015). Continuing to expand the reach of health care should always be a priority of health care professionals because they should strive to reach every patient that ever needs care all around the planet.
I personally like the idea of achieving the best outcomes at the lowest cost. The businessman inside of me loves this strategy because it achieves the biggest profit for the industry that can then be reinvested into new initiatives and greater technology that could make health care practices easier to manage and easier to access. Focusing on what the patient needs also helps patients realize that the health care industry is not only out for a paycheck and instead have their interests and needs at heart, so they feel safer, welcomed, and ultimate healthier when they are admitted into the system. I like the idea that medical facilities are dedicated to specific conditions to provide the best care for their patients. The idea is cool, but the location of these facilities could really become a problem. Let’s say someone has heart related problems but the closest heart related facility was in another state, I feel like the inconvenience of that would hinder providing patients with the best care possible to achieve the maximum good outcomes. The value agenda has great points that detail how the new transformation of the health care industry should be grown. Every point made in the agenda is valid and is a necessary change to build a great health care system. I like that the forefront of the initiatives and the ideas presented is the universal goal of maximizing patient outcomes. I like this because at the end of the day that’s what medical professionals should always be striving for. Making sure everyone on this planet is happy and healthy.
Sources
Porter, M., & Lee, T. (2015, September 14). The Strategy That Will Fix Health Care. Harvard Business
Review. https://hbr.org/2013/10/the-strategy-that-will-fix-health-care