The fact of the matter is--25% of the patients generate 83% of the costs in home health.
My friend Jim Pyles says, if you want to understand the way healthcare in the USA is being directed, just follow the money. In our money driven system this is sound as an analytical principle.
How will Value Based Reimbursement shape the way money flows in and out of healthcare?
Here are some trends that indicate the future of healthcare that I believe are becoming indicative of the future of the segment called US healthcare.
- The patient comes first
- Patient satisfaction/ consumer feedback and 'crowd sourcing' of technologies, solutions, and "cures" or therapies- will create 'movements' and tribes/ followers, all who act as experts due to their experiences, will become more pervasive as the Boomers "command the system to meet their needs".
- I love the quote attributed to Truett Cathey, the founder of Chic Filet, when asked what his geographical expansion plans were, he replied," wherever our customers tell us to go".
- Wherever the boomers want their healthcare, that will influence the way the system provides healthcare delivery. Boomer preference will most likely be --if healthy and ambulatory, in the community(Urgent care/Minute Clinic), and the chronically ill who are not as ambulatory, will prefer home to hospital.
- Cost is the key driver
- Today, insurers are beginning to "follow the money" and recognize that not only that their beneficiaries PREFER home centered care, but that it is the most cost effective method of healthcare delivery. Not hospitals, not rehab, not community clinics, not skilled nursing centers(nursing homes).
- Systems will just ask the patient their preference...and they will prefer close to home, which happens to be the lower cost delivery system, due to its convenience.
- Nurse practitioners will finally be recognized as the most effective PCP in the system, and states will finally look past the AMA and get the NP's approved.
- Teams of Professionals must collaborate and coordinate
- In order to effect change in the costs of care, chronic patients must be directly cared for by Cross Disciplinary Care Teams, who each apply their skills in a technologically streamlined delivery system.
- This Collaborative leadership emphasizes an intuitive capacity for patient satisfaction, empathy, and requires skills of organization, communication, technological sophistication, political savvy, and systems thinking.
- Social work's influence and skill sets are more and more important in bringing doctors, nurses, administrators, caregivers. families, and patients together to bring about the Triple Aim. The Independence at Home Innovation Model may be the answer for a care model.
- The Feds will tighten their regulatory structure.
- They are pushing towards getting good press. Cost savings is good public relations for the Feds. yet, government sector costs...don't stop growing.
- Bureaucracies are like glaciers in the ice age, they grow, without any one noticing they're moving at such a steady pace. Look back 50 years, and look what has happened, resulting in what we know as CMS(Center for Medicare/Medicaid Services).
- Insurance will follow the government's coding system( ICD-10) and will set the standards for Value Based Purchasing of Healthcare Services.
- Patient satisfaction, and citing of service quality experience online is a big and increasingly important component
- Those system operators who establish a strong, shared vision and positive "patient experience focused culture", and have a very sharp eye for cost effective processes, will operate in a sustainable manner.
- Some will optimize and perform better than others, and some won't, like always.
These are but a few of the things that should work themselves to a position of leading importance as this "sea change" of healthcare reorganization continues to permeate. The complexities are immense and the stakes are high. Let's participate in being the systems thinkers would help steer the industry in the best alternative future state reality.
