HCI3 Update from the Field: 2011 in Reflection

Submitted by francois.debrantes@hci3.org on Thursday, January 5, 2012 - 06:09

Newtown, CT – January 6, 2012

As we start 2012, it's appropriate to reflect on the distance travelled in 2011 and the distance to be travelled these next twelve months – First, the leadership at the Innovation Center has yielded tremendous dividends in shifting the industry's mindset from volume to value-based payment. The responses to the various initiatives – ACO Pioneer, Bundled Payment, Comprehensive Primary Care – have been breathtaking and illustrate how ready the leaders of medicine are to move away from siloed healthcare to greater patient-centricity. Second, the private sector has continued to push for greater value for every health care dollar spent. Pepsi joined Delhaize, Lowes and many others in driving employee purchasing to higher value providers. They've looked at their data and asked a simple question: Why are we paying $1.50 for something we can get for $1. And late last year we asked the same question of all employers and of Medicare by comparing the average price paid for a total knee replacement procedure by commercially insured plan members, Medicare beneficiaries, and residents of Stockholm County in Sweden. Third, and more concerning, transparency in quality has taken a hit as the focus on cost has increased. Some state hospital associations have retreated from reporting quality measures within the state claiming duplication with federal efforts. Others are sharpening the gag clauses they impose on health plans to avoid the type of market share shift that employers are embracing. Two steps forward, one step back.

What this means to you – Make no mistake, the revolution in a multi-trillion sector of our economy will not happen without a fight. In any shift of this magnitude there will be winners and losers, and the losers won't lose willingly. As such, the distance to be traveled these next twelve months will seem greater than it truly is because resistance will mount as the inevitable reality of change becomes more apparent. We cannot and will not waiver in our determination to see the shifts needed occur. For every attempt at a gag clause, any attempt at non-disclosure of quality measures, there must be a swift and immediate response: Shining a light, shaming the culprits, and taking counter measures. That has to be our unwavering resolution in 2012. No more steps back. No retreat. No surrender.


Francois de Brantes
Executive Director
Health Care Incentives Improvement Institute, Inc.
w: www.hci3.org