From the Chair
Ralph Lawson, FHFMA, CPA
"We need people who consume medicine to think about health care the same way they think about buying a television set at Best Buy."
─Otis Webb Brawley, MD, chief medical officer and executive vice president, American Cancer Society
Consumers are increasingly looking for value, especially in health care. As an industry, we are on the verge of what I believe will be a cataclysmic transformation from volume-based to value-based payment methodologies that will have a significant impact on the traditional roles of payer, provider, and patient. The new normal will bring to the forefront unusual and unlikely partnerships in an effort to reduce costs and increase quality. Are you ready to build this inukshuk?a
Many healthcare providers have already begun to position themselves for success in the new era of reform. Take the recent health plan and hospital joint venture in Spokane, Wash., between Group Health Cooperative, a staff-physician model HMO with 660,000 members in Washington and Idaho, and Providence Health and Services, a Catholic healthcare system with a medical group comprising 276 physicians and professionals and 32 hospitals. The goal of the collaboration is to offer a single delivery network to health plans and employers interested in contracting with the entity. Both sides stand to make significant gains from this partnership. Group Health, which for the first time is making its physicians and medical centers available to commercial members of other health plans, hopes to extend its very successful model of care to providers not employed by Group Health to offer a more integrated approach to managing population health, resulting in higher quality and lower costs. Providence Health plans to leverage Group Health's strength in managing outpatient care and physician practices to successfully manage recent physician practice purchases as well as its continued growth in the outpatient side of the business.
Earlier this year, Baptist Health South Florida joined forces with the state's largest insurer, Florida Blue, and Advanced Medical Specialties, a 32-physician oncology group, to dramatically change the way care is delivered to a select population of oncology patients. The foundation of the "ACO-like" arrangement is the ability to successfully coordinate care in an effort to improve quality and reduce costs, with any savings shared among the three parties.
Many of the innovative, game-changing healthcare organizations in the United States have already taken forays into the brave new world of life after the passage of the Affordable Care Act, and common themes have emerged: Quality always reduces costs. Technology, specifically IT, is key to increasing value. Integration and collaboration among hospitals, health plans, and physicians must be achieved to tackle the cost challenge.
And, most important, the ability to navigate the transition resides in two words: Leadership Matters!
a. Recall the word inukshuk from my earlier columns: It is a stone landmark built by the native peoples of the Arctic regions of North America to serve as a guide or point of reference for those who follow, to help them find their way through a harsh environment that has few natural landmarks.
Publication Date: Monday, September 03, 2012