Google+
Quote
NAVIGATION
PNHP RESOURCES

Bain & Company on the absence of ‘a compelling way forward’

2017 US Front Line of Healthcare Survey

Bain & Company

The US healthcare industry is still in search of a cure—a breakthrough model that can deliver high-quality care at lower cost. Over the past five years, hospitals, healthcare groups and medical practices have adopted new management structures and systems to curb spiraling costs. But none has proven to be a compelling way forward, and the pace of change since 2015 has slowed substantially.

The US healthcare model remains firmly centered on physicians.

In fact, more than 60% of the physicians we surveyed believe it will become more difficult to deliver high-quality care in the next two years as they struggle to cope with a complex regulatory environment, increasing administrative burdens and a more difficult reimbursement landscape. After years of experimentation, physicians now want evidence that new models for care management, reimbursement, policy and patient engagement will actually improve clinical outcomes. Without it, they see little reason to alter the status quo and move toward widespread adoption.

Why change has slowed

Physicians and healthcare organizations have become more cautious about adopting new structures, systems and tools for several reasons. With the first wave of change well under way, many practices already have implemented changes that are easy or required, and are reluctant to adopt more-complex systems and tools. Physicians are particularly hesitant to embrace new systems when the clinical implications and the return on investment are unproven and the administrative burden significant.

Comparing our 2015 and 2017 survey findings, one notable slowdown has been in the adoption of value-based payment models. Many physicians anticipated a broad rollout of value-based care two years ago and a corresponding decline in practices using the traditional fee-for-service model. But few have been persuaded to switch, noting a lack of evidence that outcomes are the same or better using value-based care.

More than 70% of physicians prefer to use a fee-for-service model, citing concerns about the complexity and quality of care associated with value-based payment models. Fifty-three percent of physicians say that capitation reduces the quality of care, and most see little advantage from pay-for-performance models either. Further, many believe their organizations are not sufficiently prepared for the shift to value-based care.

The road ahead

After a decade of trying out new models, the US healthcare industry has yet to rally around an innovative approach that provides quality care at lower cost. In fact, a disruptive, technology-based solution like those that have transformed the telecom or retail industries may take much longer to develop for healthcare, although a comparable outcome seems inevitable. In the meantime, the industry will continue to innovate, with progress in fits and starts as different models gain traction in different places.

https://app.shorthand.com...

***

Comment:

By Don McCanne, M.D.

Bain & Company is a management consultancy organization. They are believed to have a good grasp of the business prospects of the health care industry. Their 2017 US Front Line of Healthcare Survey is important because it demonstrates that physicians do not believe that the current experiments in models of payment are the way forward.

The report states, “the US healthcare industry has yet to rally around an innovative approach that provides quality care at lower cost.” Dare we say that it is because we are turning to Bain-approved, value-based approaches more suited for the medical-industrial complex rather than being designed by placing the patient front and center?

The Bain report also states, “a disruptive, technology-based solution like those that have transformed the telecom or retail industries may take much longer to develop for healthcare, although a comparable outcome seems inevitable.” Inevitable? Some disruption is inevitable if we are to eliminate our current highly dysfunctional financing system that results in high costs, gaps in coverage, and mediocre quality. Technological advances may be helpful, but they need to be much better targeted than they currently are.

Instead of searching for nebulous, value-based, MBA-designed payment models, we need to adopt the already proven model of a well-designed single payer national health program. More physicians are now beginning to realize that a system designed to provide optimal care for the patients is a system in which physicians themselves will also thrive.

Stay informed! Visit www.pnhp.org/qotd to sign up for daily email updates.