3. Seven Key Trends in Health Care
1. Triple Aim
— Improving the patient experience of care
(including access, quality, satisfaction)
— Improving the health of populations
— Reducing the per capita cost of care
4. Mark Fabiano
Executive VP Altegra Health
“Whether your politics are red or blue, liberal or conservative,
no one can be against the Triple Aim.”
5. Seven key trends
2. Overhaul/reinvigoration of primary care
3. Lean management
4. Large employers marketplace clout for quality/affordability
5. Payment reform
6. Marketplace consolidation
7. The doctor crisis: preservation/enhancement of physician
careers
9. Triple Aim / Triple Failure
— Disastrous patient experience of care
— Epidemic patients falling through cracks
— Huge cost of treatment
10. Transformation of Primary Care
— Old model:
Sorry you are sick. We will try to heal you.
— New model:
We will do everything we can to prevent
you from getting sick in the first place.
11. Virginia Mason promise
We will
— Prevent you from getting sick whenever possible.
— “We cannot have any of our patients walking around in an
unsafe condition.”
12. Primary Care a Team Sport
— Rewrite the primary care lineup card
— Let doctors be doctors leading a team.
— Breakthrough: Flow in primary care
14. Virginia Mason: At the heart of three
trends
— Lean
— Primary Care renewal
— Employer marketplace
clout
15. Lean Pathway to Triple Aim
— Lean management
— Improves patient experience of care
— Improves population care
— Controls costs
— Power of lean method/tools
— Professional liability cost down 74 percent since 2005
— 20-60 percent more affordable
— Virginia Mason Institute
16. Power of Major Employers to Drive
the Triple Aim
— When purchasing non-health care goods/services, most
companies exacting procurement standards.
— Why not the same approach in purchasing health care?
17. Starbucks Marketplace Clout
— Uncomplicated low back pain
— Again, the power of lean
— From a wasteful, provider-centric approach to a lean, patient-
centered approach
18. Starbucks Specs
— Evidence-based care
— 100 percent patient satisfaction
— Same-day access
— Rapid return to function
— Affordable price for employers and providers
19. Quality up, costs down
“When employers use purchasing power in procuring health care
with the same attention they invest in buying other goods and
services, they get better quality at lower cost.”
Dr. Bob Mecklenburg
20. Understanding costs
— Identify and focus on most costly medical conditions
— back pain
— headaches
— shoulder, knee and hip pain
— other common conditions
21. Payment reform
— Historically costs hard to contain under FFS
— The more you do, the more you are paid
— What if the team paid keep Steve healthy?
22. How will you be paid?
— Capitated
— Bundled
— Reference pricing: 2011 California “reference-based pricing”
for state workers/retirees
24. Challenging transition to capitated
plans
— AQC patients treated differently than FFS patients?
— Make sure AQC patients covered on all quality metrics – paid
to do so.
26. Martin Gaynor, Carnegie Mellon
University
— We have allowed U.S. health care markets to
become concentrated and uncompetitive.
— Higher prices, lower quality, less innovation, poor
service.
— Harms consumers
27. The Doctor Crisis
— Burnout/job dissatisfaction
— "Taking physician satisfaction seriously does not mean giving
physicians anything they want, but it should mean creating an
environment where physicians are always able to put patients
first.“ Jay Crosson MD, AMA
28. From new book
— We need to liberate doctors from the work that others can
capably handle to allow physicians to focus on providing the
best care possible.
— Preserving the professional dignity and idealism of physicians
and enhancing their career experience can play a major role
in achieving a patient-centered system.