Delivery System Reform: The Time Has Come

from HealthAffairs.com/4/23/2017---

The below summary(in Helvetica font) of the healthcare system's endemic problems is indicative of both what is happening in the sphere of home based care, and what is most attractive about home based care: Lower cost healthcare service delivery.

"Delivery System Reform In Context
There is widespread agreement that the provision of health services in the United States suffers from high levels of waste and inefficiency. A 2012 report from the Institute of Medicine (IOM) estimated that about 30 percent of health spending was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Although the IOM stated that the US health system has become too complex and costly to continue business as usual, we are far from resolving these problems.

Despite numerous initiatives undertaken by providers and health care organizations to improve care coordination, the degree of fragmentation is striking. Redundancy and excessive use of services is common, as is lack of communication and data sharing among providers. In too many instances, the result is poor quality and high-cost care.

The goal of improved efficiency in health care should be a central feature of any reform effort. The key is to set in motion changes that lead to continuous improvement in the productivity of the care delivery process, which could slow the pace of rising costs without diminishing the quality of care.

While the goal of better and more efficient care is widely shared among those advocating various approaches to health reform, there is far less agreement about the federal government’s role in that effort. The approach taken by the ACA and MACRA assumes that the federal government has the know-how and administrative capacity to set the terms for what would constitute higher-value care—and, in the process, redesign the way providers care for patients. Indeed, the federal government’s role in delivery system reform—and health care in general—is central to the disagreement about the ACA: Proponents of the ACA are relatively confident in the federal government’s ability to lead a delivery system reform effort, while opponents believe more room should be made for private initiative."**

SS: No matter of the reform efforts emanate from the private sector or the government sector, it is a foregone conclusion that Home Based Care(Home Health/Medicare and Medicaid, Personal Assistance Services, and Hospice) is not only the low cost provider in the healthcare continuum, but also is preferred by the patient. 

It is the time to reiterate and reinforce the overwhelming value of Healthcare in the Home.

**The Future Of Delivery System Reform. by Joseph Antos and James Capretta, April 20, 2017