Despite the ongoing debates over healthcare reform, one fundamental question remains: which system is more efficient? For many, the answer to this question is a matter of simple economics. The cost of health care has risen in developed countries. This increase is mainly due to aging populations and the rise of chronic illnesses. In many countries, the number of healthcare systems has expanded. In the United States, a mix of private and public health care systems has been developed. In many states, tax-funded safety-net programs are also available.
One of the fundamental factors in health care is that it is designed to address the needs of the patients. When patients become sick or injured, they are often treated with the goal of restoring their health and functional status. They often feel dependent and vulnerable and may feel that their care is being controlled by treatment algorithms. Patients’ feelings of vulnerability can cause them to feel insecure and threaten their own self-efficacy.
One of the first principles of structuring a business is to organize around the customer. Healthcare providers tend to focus on things they control – such as costs or charges – and worry about patient heterogeneity not being fully reflected in reimbursements. This is legitimate, but is also a concern in any reimbursement model. In addition, providers are increasingly concerned about the accuracy of cost data at the condition level.
While the current system has been around for decades, evidence suggests that the shift to value-based health care is coming. Healthcare providers are starting to develop an understanding of the importance of outcomes data and are working to improve their understanding of these data. In particular, they are using innovative technologies to gather outcomes data, including telephonic interactive systems, web portals, and tablet computers.
The key to success in value-based health care is a shift in clinical organization. Providers must adopt a patient-centered approach, and their first priority should be measuring outcomes. The International Consortium for Health Outcomes Measurement is a collaboration of clinical leaders from around the world. It gathers best practices in outcomes data collection and develops minimum outcome sets for medical conditions.
As providers gain a better understanding of outcomes, they will be able to improve their care. These improvements will translate into stronger contracting positions. In addition, improved efficiency will help providers sustain their market share. The shift to value-based health care is in the process of being adopted, but it will take a long time to fully implement. However, evidence suggests that it is in the providers’ economic interests to align payments with value.
While some people believe that healthcare is a social good, others believe that it is a right. In either case, the question of distributive justice merits attention. For instance, while the current generation might exhaust the resources available to them, future generations may have an obligation to provide care to their children. This could mean a greater allocation of funds to prevention programs, research, and healthcare for future generations.