Today’s healthcare landscape presents serious challenges and energizing new opportunities that, if properly addressed, provide the impetus for significantly advancing the overall health of our nation and optimal health outcomes for individuals.
The inescapable and related concerns of suboptimal quality of care delivery, precipitous increases in preventable chronic illness and unsustainable escalation in healthcare costs, cause both public and private purchasers to demand significant change in the organization and financing of care delivery.
The concept of “value” has now firmly taken root.
These demands for greater value in the use of increasingly precious resources are producing effects across all sectors of healthcare-related products and services. For example, value-based delivery system reimbursement continues to advance and is increasingly supported by more robust measures of quality and cost-effectiveness.
Transparent reporting of performance is reaching critical mass, although not without controversy in some physician communities. Encouragingly, the “Choosing Wisely” campaign led by several medical societies, and supported by influential patient advocacy organizations, does signal recognition by clinicians that evidence-proven wasteful practices require serious attention.
Value-based reimbursement is also becoming aligned with value-based health benefits and value-based technology assessment. Taken together, these three initiatives are gaining a critical mass effect.
Primary care disciplines have long called for a reorganization of care delivery around patient-centered models. As reimbursement moves away from episodic, piecemeal, fee-for-service payment mechanisms towards total population, outcomes and value-based systems, the momentum of care delivery is increasingly focused on successfully addressing the comprehensive needs of each individual in the lowest cost and most appropriate care settings.
This transition is supported by innovation in comprehensive care delivery that integrates wellness, health promotion/disease prevention and public health interventions into traditional medical care delivery. This momentum is further enhanced by the emergence of new consumerism insights and tools pioneered in other industries, and new value-based benefit designs that provide financial incentives for individuals to make personally appropriate behavior and care-related choices.
Value-based technology assessment is in its ascendency as advancements in biotechnology and genomic-based medical innovations present important quality and cost challenges, as well as exciting opportunities for truly personalized care. Innovators, researchers, clinicians, patients, health plans and purchasers will all have important roles in optimizing access and appropriate use of new innovations.
The flowering of telehealth technologies that enhance prevention and clinical engagements, and increasingly robust health information technology that supports the data aggregation and analytic capabilities necessary to drive modern health systems are also significant advancements.
Responsible stewardship and intelligent integration of this increasingly diverse array of health and medical care resources is a responsibility for all stakeholders.
This is certainly a time of challenge and uncertainty; however, this is also an important historical moment of unprecedented opportunity to more successfully address the fundamental civilizing questions of whether we shall live or prematurely die and the quality of that survival free from preventable misery and agony.n
Dr. Reed Tuckson is the founder of Tuckson Health Connections, a healthcare consulting firm. He will be the keynote speaker at the Connecticut Health Council’s Sept. 30 event at the Hartford Marriott Downtown.
