This month’s blog with Dr. John Glaser, Senior Vice President, Population Health at Cerner, touches on the importance of knowing when to make the shift to value-based care. Providers are straddling the line between volume and value and their timing for moving toward the value-end of the spectrum is ripe for risk, but also for reward.
Read more insights from Dr. Glaser in our latest Four Questions Series below.
Do you expect investments in care coordination to increase or decrease over the next 10 years?
I expect investments in care coordination to increase largely due to the progressive movement to value-based care. This movement will increasingly put an emphasis on providers, health plans, employers – everyone accountable for care – to manage the total cost and quality of care. Whether it’s diabetes management or a hip replacement, it’s not just the quality and cost of care in the hospital, but the total cost across all venues. To manage that total, you have to have sophisticated care management and care coordination, so I expect investments to increase a lot over the next ten years.
What challenges are value-based care programs facing today?
This movement to value-based care has been an incredibly significant change in the business model for most providers. They’re going from reactive care for the sick to proactive management of health; from fragmented care to integrated care; from being rewarded for volume to being rewarded for quality and efficiency. Changing a business model is hard: hard for financial services, hard for retail and hard for healthcare. All of these require changes in technology, organizational processes, culture, and reward systems. This also requires changes in traditional boundaries between providers and payers. This massive change is already underway, but it will take time, years, to really pull this off. The challenges are multiple –and related–across operations, across strategy, across technology, across the people they hire, and are multi-faceted. The major challenge is providers need to come to grips with the change that lies in front of them and how to effectively go after it.
What are some of the biggest challenges or hurdles for healthcare providers?
There are a couple of hurdles, one of which is that for most providers today, it is still a fee-for-service world. They are rewarded for volume and it isn’t yet a world where they are rewarded for being efficient. Since they’re straddling two worlds, how do they know when to shift from one foot to the other? If they shift too early, they could financially hemorrhage. But, if they shift too late, they could be behind the curve.
A lot of the early experiences with new payment arrangements are showing mixed results. For example, Medicare has several dozen different payment arrangements under way. Some work very well, while others might not work so well. We’re collectively learning and experimenting as we go, but, we’re asking providers to move to this new world, one where those that have gone before had mixed experiences. How do they avoid the risk of potentially failing or hurting the organization?
Providers are challenged with knowing when to make this shift, but know that there are people who can help you make the journey in a way that reduces the risk.
What technologies or companies have you seen making an impact across the healthcare landscape?
There are categories of technology that are making an impact. One category includes PatientPing (Pings). Technologies in this category significantly improve the provider’s ability to coordinate care and manage care across care venues, time, and populations of people. These technologies are remarkably important and will continue to be for quite some time.
Another category is technology that reaches out to you, me, and everyone else as a consumer. It could be a device measuring blood sugar, or helping us to eat better and exercise more. It could be joining communities of people with a common health challenge, such as Alzheimer’s disease. At the end of the day improving care requires that we as patients and consumers take responsibility for our health.
The third category is intelligence and analytics. There has been extraordinary innovation by tech giants such as Google, Microsoft, IBM, and Amazon to create very sophisticated analytics (e.g.. Watson). These analytics do a range of things like find patterns in data that suggest treatment A is better than treatment B. Or shape the user interface in different way; the tool would know that you and I are different, so we have different interfaces that adapt to our different tastes.
There has been a broad introduction of intelligence into our personal lives that will now ripple into healthcare. While there will always be advances in things like sensors and cloud computing, these three areas are where the energy will be directed and real progress will be made.
