President Obama spoke this week in front of the AMA, and gave a great speech about how we need to really improve how we deliver healthcare. He noted that we won't get there by simply implementing electronic medical records or enouraging preventive care. He understands and said clearly that we need to improve our payment system so that it encourages quality and efficiency, thus resulting in lower costs and happier patients.
My full article was posted at the HISTalk site:
My ending comments were as follows:
I agree with President Obama - we can do better. It is quite clear that our current system is simply not sustainable long term, nor is it a “fair” system due to its inability to provide access to all Americans. So I hope we will be able to tell our children in ten years that we were part of the movement which allowed us to become a nation where we can provide the best healthcare to all Americans in the most convenient and cost-effective way possible. It is right financially, it is right morally, and it is right clinically. Now Mr. President, just make sure those words move into action.
I also responded to a comment about the concern around non-compliant patients:
My best comment is that there is no single answer, but if we create the RIGHT INCENTIVES - then let the market and providers be creative and innovative in figuring out how to deal most efficiently with both the doctors/patients who want to work together, as well as those who don’t. America has always been built on that concept - and it can be a double edged sword since the reimbursement system has to be well balanced for quality and cost, but I think we are much closer in a setting where we get “care coordination” PMPM fees vs. simple FFS fees.
...with the right incentives in place - it will be very interesting to see what people come up with - I still remember hearing about the pre-natal clinic which gave away lottery tickets to get all the economically disadvantaged mothers to come into the clinic - it worked well and created an enormous ROI by decreasing pre-term births. Hmmm… maybe that is the answer for the rest of America - see your doctor, be compliant, and get a national lottery ticket!