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Porter on Value in Health Care

Porter on Value in Health Care. Presentation to Center for Public Leadership, Harvard Kennedy School: http :// youtu.be/Z3fKyWydweo. What is the Goal?. Access? Availability? Equity? Cost containment? VALUE = Outcomes -:- Costs. Outcomes. Multidimensional Over time…. Cost.

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Porter on Value in Health Care

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  1. Porter on Value in Health Care • Presentation to Center for Public Leadership, Harvard Kennedy School: http://youtu.be/Z3fKyWydweo

  2. What is the Goal? • Access? • Availability? • Equity? • Cost containment? • VALUE = Outcomes -:- Costs

  3. Outcomes • Multidimensional • Over time…

  4. Cost • Total cost of all services for full care cycle

  5. Six Strategic Objectives • Organize system around patient • Measure outcomes and costs • Pay in “bundles” • More connection, less all-service stand-alone • Break down and out of narrow geographies • IT, but not for a broken system

  6. Obj. 1: Organize around patient

  7. Obj. 1: Organize around patient

  8. Cycle of Care

  9. Obj. 1: Implications • “From organizing around the exception to organizing around the rule” • Primary Care: organize around specific patient populations • Volume for specialization and dedicated facilities

  10. Obj. 2: Measure… the whole chain

  11. Obj. 2 • Now: only measuring processes… • Must measure outcomes

  12. Obj. 2: Measure… Outcomes

  13. Obj. 2: Measure… Costs

  14. Obj. 3: Pay in bundles

  15. Obj. 4: Connections

  16. Obj. 6: IT

  17. Implications for Government • Establish universal measurement and reporting • Shift reimbursement systems  bundled • Medicare to lead… • Remove obstacles to integration • Stark Laws limiting referrals (“conflict of interest”)? • Separate payments to hospitals and doctors? • Illegal to hire a doctor as an employee? • Open competition • Encourage patient responsibility • Set standards and mandate EMR adoption

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