Reform's Bright Side: You Get to Reinvent How Care is Delivered

Philip Betbeze, for HealthLeaders Media , November 12, 2010

As I talk to senior leaders across the country during the course of my job, that's the positive attitude on which the overwhelming majority of my sources seem to be leaning. Color me surprised as I've encountered this attitude time and again. I've been conditioned, covering healthcare for a decade, to (understandably) hearing wailing and gnashing of teeth by the government regulation change du jour. But instead of focusing on the negative, many CEOs are seeing the new normal as an opportunity, as befits leaders' generally optimistic personalities.

Chris Borr, as the vice president of marketing for McKesson, one of the industry's largest IT companies, hears frequently from his colleagues about individual stories of innovation that are still in the early stages of execution.

For example, while he hasn't seen any really bold moves to address the accountable care organization concept central to PPACA, he sees opportunities for innovative healthcare leadership to define those organizations, while regulators provide a framework in which hospitals, health systems, health plans and physician practices fill in the blanks. Many organizations are beginning to debate what an accountable care organization actually is.

"There's a myriad of structures that it could take and it's still a definition that's waiting to be written," says Borr. "That's an opportunity in many respects. The government doesn't have a good track record in defining or prescribing how care should be delivered, but they do have a good record on setting minimum expectations that allow the market to figure it out."

Borr's not overly concerned.

"There's no alarm with [ACOs] that they aren't tightly defined," he says. "That's actually a benefit."

The other thing that's glaringly apparent is the level of concern in being able to place large bets for their orgs with very little information to back up the decisions on where to place those bets.

Philip Betbeze is senior leadership editor with HealthLeaders Media.

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4 comments on "Reform's Bright Side: You Get to Reinvent How Care is Delivered"

hsr0601 (11/14/2010 at 4:30 AM)
Title : The reps Will Stomp On Middle Class & Economy. ? The SHAMELESS reps' principal : No principal & power-only ! ? 1. The reps' campaign slogan, spending cut, has nothing to do with the deficit cut. ? The Bush tax cut for the wealthy will add an additional $700 billion to the deficit over a decade. Under the existing Bush tax cut for lavish bonus parties, a sole job plan for the republicans, the country already saw millions of job cuts. And hence it's the right time to ask themselves as to how they can pay for it. ? As for the Democrats, sound investments = deficit increase. As for the reps, empty giveaway policy = SHAMELESS top priority. ? 2. Over the duration of healthcare debate, using the preliminary cost analysis of CBO, the reps opposed the public option stubbornly, but after the release of final score, they have been defiant on the referee. ? Inaction cost in relation to health care reform totals $9trillion over the next decade. The nonpartisan Congressional Budget Office estimates that reform will reduce the federal deficit by $143 billion over the next 10 years and as much as $1 trillion during the following decade ? 3. In view of Medicare & Social Security : ? "Don't Let Government Touch Your Medicare & Social Security" "We will instead Stomp On Your Medicare & Social Security" ? 4. Jobs ahead in another Bush era ( = Entire Downfall ) ?? I think D.S. is going to realize vividly how Bush era wrecked economy.

Robert Trinka (11/12/2010 at 6:48 PM)
I appreciate your optimism and that of the provider community, misplaced as it may be. I don't think everyone really understands how potentially toxic PPACA is to the healthcare system. PPACA can only succeed if costs are [INVALID]ntly controlled. If you are a doctor, hospital or other provider, your reimbursement will be reduced and reduced and reduced some more!! Since 85% of the insurers' "premium" must be spent on actual healthcare costs and the "premium" is regulated by the government, how is it that providers think they can come out ahead? The federal and state governments will grind down the premium that the insurers that participate in the exchanges can charge and the insurers will grind down reimbursement to providers. Utilization and reimbursement will be controlled to the point where obtaining timely care becomes a public problem. Then, some stability may take hold, but few will like the new status quo. You can safely assume that the federal government's support of the yet undefined ACOs and "Medical Homes" are a facade and will not result in more reimbursement for higher quality. If any provider wants to control their own destiny and control the quality and cost of care, the PPACA legislation will need to be repealed. I suggest that the short and long term planning be dedicated to that end - repeal. Read the bill and the regulations that are being promulgated!! Don't take the Democrats word on this. This reform is premised totally on control of care, of reimbursement,of medical decisions, of patients, of hospitals, of insurers and of the healthcare system generally. There is no indication of empowering providers to take charge and improve the system. Sorry, but that is the way it is.

Patrick Plemmons (11/12/2010 at 1:41 PM)
Phil - An excellent article, but the headline doesn't fit the body of the piece. Providers are most certainly not going to be allowed to "Reinvent How Care Is Delivered". If by that you mean doing the same or more and getting paid less, then sure, reinvent away. Through Obamacare, the Feds now have the means to control the healthcare industry to a much greater degree than currently, and it should be clear that their end game is a government-run, single-payer system. Anyone who thinks private sector innovation is going to flourish under this crew is naive. They are all about command and control and any outbreaks of innovation will simply be window dressing. Let's hope Obamacare can be repealed and true market-based solutions can be found.




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