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The Commonwealth Fund Commission on a High Performance Health System Report Focuses on Delivery, Not Just Cost and Coverage

Posted Sep 26 2008 5:17pm

by Ed Howe

Over the past several weeks, I have been beating the drum that healthcare reform must address how care is delivered, not just how it is financed, nor how comprehensive or voluntary any reform will be. The Commonwealth Fund Commission on a High Performance Health System just released a report hitting on many of the same issues. Good reading, now available online.

Their conclusion is:

“Our fragmented healthcare delivery system delivers poor-quality, high-cost care. We cannot achieve a higher-performing health system without reorganization at the practice, community, state, and national levels. This report focuses on the community level, for which we have identified six attributes of an ideal delivery system. Our vision of health care delivery is not out of reach; some delivery systems have achieved these attributes, and they have done so in a variety of ways.

“We can no longer afford, nor should we tolerate, the outcomes of our fragmented health care system. We need to move away from a cottage industry in which providers have no relationship with, or accountability to, one another. Though we acknowledge that creating a more organized delivery system will be difficult, the recommendations put forth in this report offer a concrete approach to stimulate greater organization for higher performance.”

As healthcare professionals and stakeholders, we need to heat up the discussion and debate on this critical subject. What needs to be accomplished is just one issue. How it can be best accomplished is another issue.

I would like to see the marketplace freed up to drive change. Others, perhaps most, would mandate regulatory and accreditation rules to drive change. The best results might come from a mixture of both.

American healthcare needs change, but we cannot start with a blank slate. A solution needs to shatter the status quo, but provide vested interests a future in which they can prosper. Small, incremental change will not get the job done.

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