Many healthcare organizations have quality improvement efforts and value initiatives like accountable care organizations, but most of them don’t improve health or save money. They fail. The very ambitious comprehensive primary care plus program (CPC+) from the Medicare Innovation Center failed on both counts. These programs fail because they don’t target the right segment of high-risk, high-cost patients. They also fail because they have pieces or part of what is needed, but they don’t provide a comprehensive solution. They don’t provide care that is focused on the needs of the patient. Success requires targeting the right population along with new science, new systems, and a new payment model.
Brent James has written a great article that ties value-based care to Deming’s core quality improvement work that is so pervasive in other industries. He addresses other factors that must be changed if we are to ever cross the quality chasm. Check out his summary of the reasons that American healthcare is broken:
“The first step—the opportunity—in improving quality and process is determining where an industry falls short of its theoretic potential. Healthcare falls short in the following ways:
Massive variation in clinical practices (making it impossible that all patients receive good care).
High rates of inappropriate care (where the risk of harm inherent in the treatment outweighs potential benefit).
Unacceptable rates of preventable care-associated patient injury and death.
A striking inability to “do what we know works” (crime of omission).
Huge amounts of waste, leading to spiraling prices that limit access to care.”
It is really that simple and it can be fixed. Our failure to address these issues is the reason we have poor outcomes at high cost. Let’s roll up our sleeves and get started.
Absolutely! It is absurd nowadays to ignore the white elephant in the room - the root causes of most of the chronic illnesses, such as poor diet with too much processed foods, sugar, a literally Cyanide like poison and carbohydrate, sedentary lifestyle, high mental stress and environmental toxins. Early detection and primary prevention permeates ALL stages of chronic diseases prevention, the earlier the better. We known the science behind these root causes and have the safe and effective tools to reverse most if not ALL the chronic illnesses. Time to do this now. Lives will be saved and prolonged for a fraction of the costs demanded by the current I call the "Late Stage Seeking Profiteering American Medical Industrial Complex Kabuki Dance Theater! Enough! This is way OVERDUE! Time to take control of our own destiny for the people's healthcare 21st Century and beyond!