The road to quality in healthcare
UnitedHealth recently announced it will become the latest insurer to overhaul the way it pays medical providers.
UnitedHealth is targeting the traditional system that pays hospitals and doctors for each service provided. Under the new plan the carrier is rolling out, part of medical providers' compensation could be tied to goals such as avoiding hospital readmissions and ensuring patients get recommended screenings.
This is a positive move for many reasons. The insurer is saying that procedures and care that do not add value should not be paid for anymore. It is a strategic move that will help encourage medical providers to keep people well and out of hospitals and away from expensive procedures that don’t add value to their overall health.
End of life care and chronic care are just two areas where healthcare tends to over-spend. By changing the way we treat and care for these patients, we can begin to change the trend of providing tests and services that offer little to no value.
When you change the pay structure for medical providers, you can change behavior. If you drive people to quality and low cost, that is what you will get. As insurance companies begin to require quality care, we will see patient days decline. Primary care doctors will become more involved in the coordination of preventative care. The number of expensive diagnostic tests will also decline.
The American people need to understand that more care is not better care. Changing this thinking will take time. Coordination of care is critically important, especially for the chronically ill. Primary care physicians need to be the leaders and coordinators of care. IT systems need to be connected for physicians to share information about care and to avoid repetitive procedures and tests.
Improvements need to be geared toward changing trends and mindsets for both patients and medical providers. Only when we change the mindsets of both will we truly be on a path to better, smarter healthcare.
Kester Freeman blogs regularly at Action for Better Healthcare.
