Amazon, Berkshire Hathaway and JP Morgan Chase might, possibly be able to reform the U.S. health care finance and delivery systems by shocking sense into people.
For everyone else, making any big, dramatic changes in the system will probably be a hard. slow process.
A health insurance executive and two hospital company executives talked about why health system change is hard, at least for everyone but “AmBerMorg,” today in New York, at a health care conference organized by S&P Global Ratings.
S&P Global brought a few hundred health care executives and money managers together to brief them on the current state of the health care sector. At one point, the conference team had participants use their cell phones to name their single favorite strategy for improving the U.S. health care system.
A few picked killing the Affordable Care Act, or an even more complete form of deregulation. A few picked improving the ACA, or shifting to a single-payer, government-run health care system.
More than half picked shifting to a “value-based” system, or arrangements that pay providers based on the quality and efficiency of the care provided, rather than a fee for each service provided.
Dr. Stephen Klasko, president of Philadelphia’s Jefferson Health Hospitals health care system, said during one panel discussion that shifting to a value-based health care approach is probably a good idea, but he said one major obstacle to that transformation is a lack of realism.
“No one wants to do the difficult things,” Klasko said.
For hospitals, simply getting the payer data needed to track what’s really happening with care is difficult, and realigning provider reimbursement rates to turn primary care doctors into managers of medical homes is difficult, Klasko said.
Today, Klasko said, dermatologists often earn 20 times more than primary care providers.
He said a primary care doctor told him, “You want me to be a quarterback, but you pay me like a kicker.”
Where do hospitals fit in?
Kevin Conlin, president of Horizon Blue Cross Blue Shield of New Jersey, said problem is that would-be reformers tend to focus mainly on spending on inpatient hospital care.
“The hospital ends up as the catcher’s mitt for all of the problems,” Conlin said.
Klasko and the other hospital company head on the panel — David Vandewater, the chief executive officer of Arden Health Services — agreed that hospitals need to work with other players to reduce the hospitalization rate.
“If a patient doesn’t need to be in our hospital, they shouldn’t be in our hospital,’ Vandewater said.