Posts Tagged ‘Affordable Care Act’

New Healthcare Models Stand “Standard of Care” on Its Head

December 18th, 2012
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As I watch the power in healthcare shift away from physicians/providers toward consumers/patients (enabled by the wide access to information and driven in part by higher co-pays), I can’t help but to observe the affects of the Affordable Care Act on both this new power and the bedrock concept of healthcare delivery—“standards of care”.
Rob Lamberts, a physician who switched his practice from fee-for-service to “direct care” (in which patients buy in as a member instead of paying for each procedure and visit, and receive a basic set of services), has compared the changes in healthcare delivery to the upheaval caused by digital cameras. Just as the move from film to digital imagery brought photography closer to the consumer, mobile apps and web-accessible information will move healthcare delivery closer to customers (a.k.a., patients). Film companies like Kodak failed to recognize the disruptive innovations wrought by digital photography; could consumer power provide the same disruptive innovation to healthcare? As healthcare industry expenses approach 18% of GDP, the unsustainable weight of healthcare costs practically beg for such a disruption.
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First HHS Innovation Fellowships’ Meeting Focuses on New Measures of Quality in Healthcare

December 10th, 2012
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In its quest to find ways to reduce healthcare costs but boost healthcare quality, the U.S. Department of Health and Human Services (HHS) launched its first fellowship program in September. For the next year, I’ll be a technical advisor on the part of this program that focuses on quickly developing ways to measure clinical quality under the new healthcare act.
I’ll be working on a team with Mindy Hangsleben, an innovator in Lean technology at Intel in Portland, Oregon. We’ll be examining the challenge presented by the Affordable Care Act, which aims to move reimbursements from “fee for services” to” fees for performance.” Our questions are: “how do you measure performance? How do you pay for it?” Some aspects of health care delivery are easier to measure; e.g., what percentage of the relevant population gets a mammogram. But basing performance upon a more holistic measure of patient outcomes is tricky because all patients are not equal, and a comparison and ranking of outcomes is not easy. In addition, we’ll be looking at ways to determine the role played by various electronic health records (EHRs) in the capture of these performance parameters, as required under the new Health Information Technology for Economic and Clinical Health (HITECH) Act.
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