Consulo Indicium 3/7/18
Information for your Consideration…
Consolidation Continues – I’ve been predicting it for at least a decade – if not longer – and, the Catholics seem to be at the head of the consolidation movement among health care systems. In case you have not been watching, Ascension Health (St. Louis, MO) and Providence St. Joseph Health (Seattle, WA) are moving forward with their mega-merger to create the largest not-for-profit health system in the nation. The combined entity will reach over 27 states creating a chain of 191 hospitals and over $45 billion in annual revenue. While it does not quite reach the $61+ billion of Kaiser Permanente, the reach is further. And, then there is the $28+ billion merger of Dignity Health and Catholic Health Initiatives extending over 28 states with 139 hospitals. Hmmmm. What or Who is next? And, will we have 10 systems in 10 years? We’re moving in that direction…
Technology Disrupting Health Care Delivery – Don’t Bet On It Just Yet! – Perhaps I’m getting a cynical or perhaps a bit more realistic. I think it’s more the latter than the former 😊. A recent article in The Washington Post caught my interest on the topic of technology disrupting health by summing up the current state of affairs with the headline – “…Don’t count on it”. The article surveyed a number of interesting approaches and ideas related to the use of technology for fostering greater efficiency and effectiveness in care delivery using virtual support and delivery. For example, a symptom checker was developed by IBM and offered to its employees but the use rate was abysmally low – less than 10%. Why?
In essence, it’s not the technology – it’s the approach we take to paying for services. My perspective is that as long as we have a “fee-for-service” or piecemeal payment model we will get piecemeal services and continuation of the existing system – which is costing far too much. It is only if health care moves towards a “value-based” payment model that real change will begin to occur. Health care is moving toward high deductible plans and that is causing some consumer shift. But, my perspective – for what it’s worth – is that without the move toward value-based care delivery we will only be managing costs at the margin or around the edges of health care. No big dent will be made in shifting or transforming health care. We are beginning to see such moves in selected geographies around the nation where value-based care or accountable care organizations are beginning to take hold such as Oregon, Washington and North California; the Upper Midwest; and, the Northeast and Central Atlantic areas. But, the rest of the country continues to be firmly planted in the FFS model. But, is it important?
On the whole, it’s incredibly important. Just the growth in the Medicare eligible population must drive the change if nothing else. The current trajectory is not sustainable and so policy change which encourages efficiency, effectiveness, quality outcomes and customer satisfaction should be at the forefront of our thinking as we consider redesign of health care. It those elements happen, the shift will be dramatic and swift. It’s not a matter of if. It’s a matter of when! Are you getting ready? By the way, when “when” occurs, technology will be a core facilitator of change… And, “when” is knocking on the door…
