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‘Chasing our tails’ on healthcare costs

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Richard Embrey, M.D., is chief medical officer and vice president for population-health management of Fishersville, Va.-based Augusta Health. He was interviewed by Becker’s Hospital Review. Some of the interview is below:

“Question: If you could eliminate one of the healthcare industry’s issues overnight, which would it be?”

“RE: The complexity of healthcare. Healthcare has become so complex that it is difficult to identify areas to improve. In fact, I would say we’re trying so hard to reduce costs that we may actually be adding costs to healthcare. We’re chasing our tails — as we try to solve our problems, we’re creating more problems.”

“Q: What do you see as the biggest population health challenge facing the Fishersville, Va., area?

“RE: Identifying patients with chronic diseases. A lot of people aren’t very compliant and don’t like to use the healthcare system, so it’s hard to find the patients who need our help. They wait until it’s too late and then come in with problems that are much more severe than they would be if we’d found them earlier.”

“Q: What keeps you up at night?”

“RE: Is healthcare sustainable? Are the costs of healthcare going to escalate so fast that people are going to lose value?”

“Q: The session you’re leading in April is called ‘Kenneth Arrow Fifty Years Later: What Has Changed and What Has Remained the Same?’ Could you give a brief preview of the session?

“RE: In 1963, a famous economist named Kenneth Arrow wrote a paper called ‘Uncertainty and the Welfare Economics of Medical Care.’ He was commissioned by the Ford Foundation to do this before the launch of Medicare. At the time, there were a lot of concerns about socialized medicine and whether insurance would lead to more utilization of healthcare.

“In the paper, Dr. Arrow wrote about uncertainty and made a point that everybody has forgotten in the past 50 years regarding uncertainty and not knowing whether someone’s going to get sick. The incidence of disease and efficacy of treatment cause all kinds of abnormalities in the market of healthcare, and those problems also cause an increase in cost.

“It was the first paper on which the field of healthcare was founded, but Dr. Arrow didn’t stay in healthcare. “Uncertainty and the Welfare Economics of Medical Care’ was the most important paper in healthcare that nobody in the industry has ever read. I plan to go back and review it for people. I hope a refresher will help people focus on what we’re trying to do in healthcare today.”

To read the whole Becker’s piece, please hit this link.

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