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Posted by / 28-Jun-2017 15:22

Mandating and delivering

These cross-subsidies introduce major distortions in the supply and efficiency of care.The inability to properly measure cost and compare cost with outcomes is at the root of the incentive problem in health care and has severely retarded the shift to more effective reimbursement approaches.Outcomes for any medical condition or patient population should be measured along multiple dimensions, including survival, ability to function, duration of care, discomfort and complications, and the sustainability of recovery.Better measurement of outcomes will, by itself, lead to significant improvements in the value of health care delivered, as providers’ incentives shift away from performing highly reimbursed services and toward improving the health status of patients.

The cost of treating a patient with diabetes, for example, must include not only the costs associated with endocrinological care but also the costs of managing and treating associated conditions such as vascular disease, retinal disease, and renal disease.Current health care reform initiatives will exacerbate the situation by increasing access to an inefficient system without addressing the fundamental value problem: how to deliver improved outcomes at a lower total cost. And the remedy does not require medical science breakthroughs or top-down governmental regulation.It simply requires a new way to accurately measure costs and compare them with outcomes.The proper goal for any health care delivery system is to improve the value delivered to patients.Value in health care is measured in terms of the patient outcomes achieved per dollar expended.

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