Can Todd Park ignite a technological revolution in the health care industry?
Over at The Atlantic, I profiled Todd Park, the chief technology officer at the Department of Health and Human Services, detailing how he is opening up the health care data floodgates for the tech community:
Park first got a taste for the massive blockades hindering payment reform when he and his partner launched Athenahealth. Before it became a software company, Athenahealth was focused on maternity care. The team wanted to scale a model where instead of assigning a doctor to a pregnant mother, you also assign her a midwife, a nutritionist and a case manager. Though the upfront costs are slightly higher, studies found that this type of care radically reduces the chances of costly complications with the mother, which drives down costs overall by as much as 20 percent. So representatives of Athenahealth approached the major health insurance companies and proposed a new payment model: Instead of paying for professional services, the insurers would pay a global fee for all care — hospital care, physician care, lab care — so that if Athenahealth could keep the mother healthy, lower the rate of complications and therefore lower costs, it would be able to more than cover the cost of the additional upfront preventive care, benefit financially and in the process drive down the total amount of money the insurers had to pay out. A win-win for all. “The insurers said, ‘Look, we completely agree with your math,’” Park said. “‘We agree with the five-year study that shows this model will work, but we can’t rewire our systems to pay you differently from everyone else. We have to keep paying you on a per-service basis, even though we completely believe that this lowers cost for higher value.’ And that was my first fundamental lesson regarding the principles of how you pay for health care dictates how health care gets delivered. Because this model can’t scale, can’t become widespread, if it’s not supported by the payment system.”
Simon Owens is the Director of PR at JESS3, a design agency in Washington, DC. You can read his blog or follow him on Twitter
6 Responses to “Can Todd Park ignite a technological revolution in the health care industry?”
Sound like he could have done something, but the insurance companies would have to get off their asses and reconfigure their payment processes. Maybe he’ll do that for them too. Ah, inertia, not just for physics issues.
Even before I lived in the East, including the Northeast as well as the South[east] and the Midwest, I cast respectable eyes reservedly when not with disdain or contempt at the Atlantic. (It even reminds me of pure elitist lefty idiocy — “Atlanticism” or “Trans-Atlanticism.”
[gagging at foreign and ALIEN examples as well as the concept]
Slammer [tm; a.k.a. Slamfu], the real issue as I’ve linked to many times is that a) we want to use the insurance model for pre-paid comprehensive health care [sighhhh], and that this model is dead!
It’s only a matter of time before something replaces the insurers, and my bet is firmly and largely on Medicare for All in the USA, that is, (FEDERAL) government replacement of much in the private sector of medicine.
Here we are, with good future vision (’cause it’s obvious and so easy to grasp at once!), again,
http://www.economist.com/blogs/democracyinamerica/2010/02/health_insurance_premium_hikes
Says DLS, whose individual “must issue” state individual insurance policy has risen from $350 monthly two years ago to $500+ now
Health care outcomes fall along an S-curve. The problem is capitation is that for a subset of the patients, the care providers lose a ton of money but that they make a set amount for a larger subset. The whole point of management is limiting the patients that are going to cost of money no matter what the physician doses. The happy talk about win-win for all leaves huge doubts in what some people are proposing.
I was looking at the line item bill from a hospital recently slamfu. The charges for what they call a hospitaler, which is a doc employed by hospital exclusively, were higher than those in private practice who were major consults on the case. I think spot checks by investigative reporters of line by line at various hospitals, would tell us more precisely what is being charged for, not only that it’s a lot. I’d like it if we had the scope and details in a reliable study that studied random hospitals, perhaps here and abroad for same malady, same general outcome. It often seems, otherwise, we’re left to say we agree/disagree, but without hard facts stacked up so we can actually measure.
Sounds like baloney to me. The insurance companies turned down a chance to make more money because their payment systems couldn’t support it? Really this is just a variation on capitation, something that was tried back in the 80′s and there were no billing problems with the insurance companies. The problem was that capitation developed a bad name since it encouraged providers to cut costs to increase their own profit, and fears arose that that would lead to inadequate care.
Da Goat wrote:
That’s the problem we’ll see eventually with “global budgeting” that will be part of Medicare for All. Conyers’s bill, for example, features this,
and don’t forget Hillary Clinton’s HMO-based “alliance system” that was a plan called “managed care under a cap.” (emphasis mine)
And then there’s the threat to Medicaid in Florida already:
http://www.fcfep.org/attachments/20110307–Mismanaging%20Medicaid%20Managed%20Care.pdf