presentation to center for public leadership, harvard kennedy school:
TRANSCRIPT
Porter on Value in Health Care
Presentation to Center for Public Leadership, Harvard Kennedy School:
http://youtu.be/Z3fKyWydweo
What is the Goal?
Access? Availability? Equity? Cost containment?
VALUE = Outcomes -:- Costs
Outcomes
Multidimensional Over time…
Cost
Total cost of all services for full care cycle
Six Strategic Objectives
1. Organize system around patient2. Measure outcomes and costs 3. Pay in “bundles”4. More connection, less all-service
stand-alone5. Break down and out of narrow
geographies6. IT, but not for a broken system
Obj. 1: Organize around patient
Obj. 1: Organize around patient
Cycle of Care
Obj. 1: Implications
“From organizing around the exception to organizing around the rule”
Primary Care: organize around specific patient populations
Volume for specialization and dedicated facilities
Obj. 2: Measure… the whole chain
Obj. 2
Now: only measuring processes… Must measure outcomes
Obj. 2: Measure… Outcomes
Obj. 2: Measure… Costs
Obj. 3: Pay in bundles
Obj. 4: Connections
Obj. 6: IT
Implications for Government Establish universal measurement and
reporting Shift reimbursement systems bundled
Medicare to lead… Remove obstacles to integration
Stark Laws limiting referrals (“conflict of interest”)? Separate payments to hospitals and doctors? Illegal to hire a doctor as an employee?
Open competition Encourage patient responsibility Set standards and mandate EMR adoption