The Greatest Health Care System
April 8, 2014
Ron Charpentier, COO – BreatheAmerica We have the greatest health care system that’s ever been available to the human race, but the rising cost of that care is making it unaffordable to more and more Americans. The government continues to play a prominent role in encouraging change and conventional wisdom clearly points to finding ways to document quality, while reducing costs. For private industry, including “for profit” and “not for profit” entities, change seems to be more about protecting the status quo or positioning strategically, rather than transforming care delivery toward better performance.
Historically, much of health care has been delivered in hospitals. A sustained trend over the past decade or so has been to move care to lower cost settings, which means less inpatient care and more outpatient care. A quick survey of the outpatient landscape reveals a highly fragmented delivery system that is designed more for independence than for performance. To make reform more difficult, providers remain largely in fee-for-service arrangements, which reward volume with little attention to quality or cost. This reimbursement methodology feeds into strong industry inertia that fights against any meaningful delivery system change. Yet change is what’s needed to lead to better health care at lower costs. Meanwhile, health care consumers and payers continue to look for relief from the rising cost of health care, which is leading them to new reimbursement methods that incent providers to better control health care costs while maintaining quality.
In this time of change and uncertainty, history tells us that innovators will emerge, face the headwinds, and position ahead of the change curve. Change is costly and difficult to sustain, but beneficial to patients, employers, and payers. So, it behooves the beneficiaries of change to reward providers who lead the move to performance based models that bend the cost curve and document quality outcomes. BreatheAmerica is an example of a provider that is fundamentally changing care delivery by using a multi-specialty platform that clinically integrates allergy, ENT, and pulmonary medicine to better diagnose, treat, educate, and manage patients with allergies and respiratory disease. The question is how quickly purchasers of health care will begin to reward new care delivery models, like BreatheAmerica, that outperform our traditional fee-for-service model?