You have probably heard a lot of heated debate about the future of healthcare. But have you heard a lot of helpful information? What do coming changes really mean for you, the patient?
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Take the concept of value-based healthcare, for example. At its most complex, value-based healthcare is an equation that balances lower cost and higher quality. At its simplest, beyond the buzzwords, it’s a set of changes designed to create better outcomes for patients. Here are four examples of those changes — and how they will improve your care.
1. No more a la carte medicine
In medicine, everything we do comes with an individual fee. Visit a doctor, that’s a fee. Get an MRI, that’s a fee. Get an MRI from a different doctor who didn’t know about the first MRI, that’s another fee.
This system does not give health professionals much incentive to look at the big picture of your care. They can get reimbursed for each test and each service, regardless of whether it was necessary or not.
“If we shift the focus to preventing problems in the first place, costs come down and the quality of your health gets better.”
David Longworth, MD
Chairman, Medicine Institute
In value-based healthcare, doctors and others get paid based on outcomes. Do patients with diabetes improve? Do people with hypertension get their blood pressure numbers down? Do they get readmitted to the hospital less frequently?
In the future, healthcare organizations will be measured on outcomes like these. And they will be reimbursed based on how they perform.
2. Standards will be high — and consistent
If you have open-heart surgery, what comes afterward will differ from hospital to hospital. When do you go home? How often do you follow up? Is home care required, and if so, for how long?
The goal is to standardize these processes in the future. That does not mean cookie-cutter care. It does mean careful scrutiny of what works and what doesn’t. Developing an ideal “care pathway” for illnesses and procedures — just like best practices in business — will reduce waste and give you the best chance of a successful recovery.
3. Your care will be proactive, not reactive
Around the country, employers (including Cleveland Clinic) and insurers are offering incentives for wellness and prevention. Quit smoking, take a course in nutrition, join an exercise class or lose weight, and your premiums get less expensive.
The idea is bigger than just encouraging healthy behavior. We spend a lot of healthcare dollars in the country reacting to health problems that can be prevented. If we shift the focus to preventing problems in the first place, costs come down and the quality of your health gets better.
4. You’ll have a home base
If you have a chronic disease, are your doctors speaking to each other? Are their electronic systems feeding into each other? In the future, the answer to both of those questions should be a resounding “yes,” thanks in part to Patient-Centered Medical Homes (PCMH).
The PCMH idea is simple: People with chronic conditions will have a team of physicians looking after them and a care coordinator making sure each doctor is up to date. It starts with your primary care physician, then spreads out to include specialists. You won’t wait for months for test results, and you’ll be able to get an appointment quickly for urgent needs rather than waiting for an opening in a busy doctor’s schedule.
None of this will happen overnight. But in the long term, value-based healthcare can save money and give you a healthier life at the same time.