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Improving the way hospitals and doctors are paid

Posted Nov 14 2011 3:22pm

Monday, November 14th, 2011

By Kester Freeman
Former CEO, Palmetto Health

What strikes me about the current moment in healthcare is that the new accountable care regulations attempt to make the concept of shared savings more attractive to hospitals and physicians. Equally exciting is the real chance we have to improve care for patients. 

I have been traveling around the country to several healthcare systems, talking about shared saving strategies with health leaders.  What we know for sure is that CMS is clearly moving in the direction of changing payment systems for good. Major health systems across the country are moving in this direction already and we are beginning to see the redesign of healthcare.

I believe we will continue on this course no matter what happens in Washington and no matter who is elected president.

Changes in healthcare payment structures will be viewed differently depending on the audience. For example those who run patient-centered medical homes will be very excited about these regulations because they support a prevention strategy. They also encourage patients to participate in their own care and to make more conservative choices with healthcare instead of having every test available to man. Specialists may not be as pleased with payment changes as we move away from a system that pays for every service rendered.

But like them or not, the changes are coming rapidly and we cannot ignore the elephant in the room. The current way we pay for healthcare in this country is just unsustainable. The burden on the American taxpayer can no longer support this payment model. 

Once CMS changes its reimbursement structure, I believe we will see other health insurance providers follow that lead. In fact, this trend is already beginning.

The change will not be easy. But those who lead and do not settle for the status quo will come out on top. Will that be your healthcare system?

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