There are dozens of leaders in the American healthcare system who are working hard to deliver the kind of care that you need—care that helps you be healthier longer at lower cost. Because of the crazy system we have reviewed in the last few posts, it is hard to identify these more effective less expensive systems.
Dr. Steve Schutzer is one such leader. He is so committed to healthcare value that he founded the Moving to Value Alliance which brings together stakeholders who want to improve our system. Here he describes the problem in his own words:
“We (CJRI-Connecticut Joint Replacement Institute) have been advocates of bundled payment models for total hip/knee and spine procedures for well over a decade now. We have predictable pricing with a warranty for related complications and readmissions. Naively, we thought the broker community and their contracted employers would have been banging at our doors to partner with us -- but not so fast. We've encountered obstacle after obstacle especially if the TPA (insurance administrator) is a BUCAH. Fortunately, there are companies such as Carrum Health that have cultivated the Center of Excellence model and scaled bundled payment arrangements.”
I recently spoke with Dr John Rodis who said roughly the same thing.
Dr. Rodis led a large health system and succeeded in providing better care at lower cost. Many organizations claim to produce those results but Dr. Rodis had the data to prove fewer hospital-acquired infections, blood clots, readmissions etc. Because his providers applied best practices and there were less complications costs went down. Better care is less expensive care. Like Dr Schutzer, Dr Rodis thought more business would come his way, but that never happened.
The message to self-insured employers is this: There are much better answers out there but you need to make sure you brokers and advisors are looking for them. We can have better health at lower cost, but we must reward the people who are doing this hard work
These two men are titans of value and true influencers in addition to being humble. I feel lucky to have the opportunity to work with them. Thank you for highlighting them.