Changing Expectations in Healthcare
What follows has been excerpted from a new paper, “Changing Expectations in Healthcare,” by Milliman Principal Jon Shreve.
Widespread evidence that our healthcare system is in need of substantial reform continues to mount. Most of this agreement centers on issues of access to affordable health insurance, the need to improve the quality and efficacy of care, and the costs associated with our present system. In order to achieve meaningful reform, a solution must address all three problems.
Of course this is easier said than done. While there may be general agreement on common goals for healthcare—increased access, improved quality, and reduced costs—there is no such agreement when it comes to how we accomplish these goals. If comprehensive healthcare reform is to occur, it should start with a clarification of the fundamental expectations for those involved in healthcare, and then incorporate policies designed to meet these fundamental expectations. Such expectations can help the healthcare system coalesce around interrelated responsibilities for patients, for care providers, and for payers.
These expectations might be stated as follows:
- We expect every individual to obtain health insurance.
- We expect healthcare providers to align health practices with evidence-based medicine, and measure and report the outcomes.
- We expect payers to develop financial incentives that reward outcomes rather than simply paying for procedures.
Establishing expectations and aligning the responsibilities of each group creates the foundation on which supporting elements for pursuing specific reform goals can then be built.