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Healthcare delivery, not just insurance, must be transformed

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A rather simple delivery system.

— Photo by Rudiger Wolk

Beyond the sound and fury over Republican efforts to kill the Affordable Care Act, some providers are renewing calls for healthcare-delivery reform, says a piece in Health Affairs by Robert Pearl, M.D., and Norman Chenven, M.D.  They have led, respectively,  two of the nation’s highest-performing healthcare systems: Kaiser Permanente and the Austin Regional Clinic.  Dr. Pearl is chairman and Dr. Chenven vice chairman of the Council of Accountable Physician Practices.

Among their observations:

“Policymakers who are focused predominantly on how to improve the health care system by providing health insurance coverage will fail unless they simultaneously focus on transforming and modifying the delivery system; otherwise, the cost of providing that care will erode any program they create, whether coverage is provided through private insurance, Medicare, Medicaid, or another method. For this reason, we encourage the new Administration and members of Congress to consult and rely on the nation’s physician leaders, in addition to health insurance executives, to help chart the course for American health care in the future.

“While there are many different ‘levers’ to pull for delivery system improvement, three are absolutely fundamental to bringing about positive change and enhancing the doctor-patient relationship: As a nation we will need to move rapidly from fee-for-service to value-based reimbursement, and from paper and stand-alone computer systems to comprehensive, integrated, and mobile electronic health records. At the same time, we will need to track quality and patient satisfaction in ways that improve clinical outcomes without overly burdening physicians. We believe that all three of these objectives can be accomplished, and that they need to be central to the approaches and legislation currently being contemplated by policymakers.”

They conclude:

“The impending crisis in health care in this country will not be averted, regardless of what happens to the Affordable Care Act, unless as a nation we move from fragmentation to integration, from volume- to value-based payment, and from paper records and stand-alone computers to interoperable and comprehensive electronic ones. If these delivery system issues are ignored in the rancorous debate about health care coverage, then no matter the outcome, the system will fail.”

To read the piece, please hit this link.

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