John Peabody, MD, PhD, FACP, is an international healthcare leader in measurement, health policy, health systems and quality of clinical care; a professor at UCSF and UCLA; and the founder and president of QURE Healthcare. An actively funded National Institutes of Health researcher, Peabody works with clinical leaders, academic medical centers and multidisciplinary teams to help healthcare organizations better align their clinical staff. For almost 2 decades, he has examined how health systems affect, and potentially improve, care quality, and patient outcomes.
While many questions on the outlook of healthcare “re-reform” remain afloat, many important insights into President Donald Trump’s potential path forward are now identified.
Both Republicans and Democrats agree healthcare is too expensive in the United States. While the focus of repealing Obamacare will affect access to care, the cost of delivery and quality of care remain ascendant challenges. Patients and payers continue to demand high-quality care and sophisticated tools to demonstrate their quality. Anchoring on these truths support a fundamental premise that providers and health systems who want to succeed in this uncertain environment must remain focused on delivering value—the highest-quality care at the most efficient price.
While many questions on the outlook of healthcare “re-reform” remain afloat, many important insights into President Donald Trump’s potential path forward are now identified. Here a few key trends indicating high-value care will remain the important differentiator for successful health systems and providers.
Other criticism from lawmakers is that there are too many programs to manage.3 While Democrats argue important innovations are more likely to be discovered by exploring different approaches, Republicans are skeptical that a federal agency can generate innovation and defer the role to states or other stakeholders like private payers. With a new Republican Congress, we could see a refocusing on certain programs that have already produced results, like bundled payments.
This year will face more pressure to control costs, both inside and outside of Washington, DC. Health systems and providers need to recognize variability in quality and cost is becoming a large influencer of both payment decisions and patient choice. Legislation and existing regulation, like the Medicare Access and CHIP Reauthorization Act, already create the impetus for moving away from a fee-for-service world. One of the most important parts of any plan to improve quality and reduce costs is engaging physicians in the process of standardizing care.
1. Cubanski J, Neuman T. The facts on Medicare spending and financing. Kaiser Family Foundation. http://kff.org/medicare/issue-brief/the-facts-on-medicare-spending-and-financing/. Published July 20, 2016. Accessed February 23, 2017.
2. Sullivan P. Lawmakers call for end to Medicare ‘experiments.’ The Hill. http://thehill.com/policy/healthcare/298769-lawmakers-call-for-end-to-medicare-experiments. Published September 30, 2016. Accessed February 23, 2017.
3. Bishop TF, Casalino LP. Symbol of health system transformation? Assessing the CMS innovation center. N Engl J Med. 2015;372(21)1984-1985. doi: 10.1056/NEJMp1500457.