Observation Deck

The Good Fight

Mark Thill

Although I am writing this in March, I have no doubt lawmakers will still be fighting over healthcare reform when you read this. As they do so, I hope – trust – that they won’t lose sight of the ultimate goal, as expressed in the Triple Aim of the Institute for Healthcare Improvement:

  • Improve the patient experience of care (including quality and satisfaction).
  • Improve the health of populations.
  • Reduce the per capita cost of healthcare.

Regardless of the outcome of the legislative battle, I’m confident that a few principles will remain standing:

  • Fee-for-value will prevail over fee-for-service. Implementing fee-for-value may not be pretty, however. We’ll have to improve our measurement and analysis tools. Everybody’s talking about IBM’s Watson. Maybe he can help.
  • The concept of “continuum of care” will prevail over the old siloed approach to medicine. What happens to patients before, during and after their hospital stay or procedure will count more than what happens in each of those venues.
  • “Population health” will prevail over medicine’s traditional mindset of responding to disease or medical emergencies. The emphasis will be on keeping people healthy, and we will increasingly recognize and address the impact of diet, exercise, poverty, housing, living arrangements, crime and more on our health and that of our neighbors.

Healthcare touches all of us in a personal way, so no wonder there’s so much contentiousness associated with its reform. But the issues of access to care, affordability of care and quality of care aren’t going to go away. As you have for years, JHC readers will continue to be called upon to help find the answers.