Healthcare Buyers Move to Change System

Healthcare Buyers Move to Change System

ON PAGES 9-14 OF THIS ISSUE, you will read our Editor’s cogent analysis of why healthcare buyers are taking active steps to measure the quality of services provided by hospitals and physicians, then make those measurements available to the public.

The Leapfrog Group’s determination to survey hospitals and post the findings on its Web site is a milestone event. Those of us who’ve been in the healthcare industry for the last two or three decades remember all the battles against making public any type of rating of physicians and hospitals. Mostly this debate has centered around public access to disciplinary findings against “bad” doctors by licensing boards. In general, public access to data ranking provider performance has been successfully avoided.

It now looks like that is about to change. Editor-In-Chief Robert Michel makes a compelling argument that the Leapfrog Group’s measurement initiative is not isolated. Comparable projects are unfolding at NCQA (for health plans) and in California (the insurer consortium that wants to measure medical group performance). This will certainly affect clinical laboratories and anatomic pathology groups, so, once again, THE DARK REPORT is first to alert our clients to intelligence and market insights of great value.

For my part, I would like to add the prediction that “consumer-concentric” healthcare will end up being the only effective solution to the renewed upward spiral in healthcare costs. However, I also predict that things will get worse before they improve, because of political ineptness in the handling of the nation’s Medicare and Medicaid programs. Lab executives and pathologists should not overlook the major influence that government-funded health programs continue to exert on the entire healthcare system.

Unfortunately for all of us, the future will be bleak before it improves. First of all, Medicare bureaucrats cannot react to new technologies and social changes with innovative solutions. Their inept pricing and reimbursement policies have already damaged our healthcare system. By not allowing the free market to establish rational pricing, Medicare is distorting the true value relationship of healthcare services. Then comes the politicians, primarily Congress. Certainly our Congress is a reactive institution, unable to innovate. Thus, it remains to the private sector, both employers and consumers, to drive positive change in our healthcare system.

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