Getting Ready for Reform
A survey by McKinsey & Company found that “only 30 percent of executives representing the health care industry in the United States say their companies are ready for reform and changing economic conditions.” The survey looked at payers, providers and pharmaceutical companies. Of the companies whose executives say they are prepared, “their top priority is to increase the value of health care by, for example, reducing the misuse, underuse, and overuse of care or increasing the quality of care received.” At other companies, the focus is on revenue and volume growth.
In much of my writing and speaking, I do talk a lot about the basics of business, such as growing volume and revenue. But the health care legislation moving through Congress moves us to a better place, looking more at value. The $2.6 trillion question is this: what do we get for this money? It’s not simply the amount of money – are we getting something, a return, on the $2.6 trillion?
The changes in physician payment proposed by CMS for 2010 are a clear indicator of the strategy they are pursuing. Payments to specialists will be reduced, payments for imaging studies will be reduced, and payments to primary care physicians will be increased. Overarching all this will be attention to restricting services that are known to be unproven or, worse, ineffective care, a problem that continues to plague healthcare.
On the clinical side, you should start a comprehensive review of clinical practices, particularly where the patients total costs are high (not just your services), and adjust as needed to meet the latest standards of care. On the business side, look at your practice operation as though you were brand new – take a new look at every step, every form, how every exam room is stocked, the layout and so on. The key is to maximize physician time with the patient, and minimize patient idle time, waiting for something else to happen. IT is part of the equation, integrated into a revamped business process.
Regardless of the final outcome of the legislation, it is incumbent upon the industry to be more effective and efficient in how the real business of healthcare – patient care – actually comes to be.
