Newtown, CT – June 28, 2013
Those who can, do. Those who can't, teach. Those who can't teach, administer – We're reminded this week of these simple truths. Across the country, those who can are doing wonderful work. Communities are engaging stakeholders in accepting the imperative for change and leading that change with concrete projects. For example, the Pittsburgh Regional Health Initiative, an Aligning Forces community, is working on local chronic care management with community hospitals (outside of Pittsburgh) and reducing hospital admissions and readmissions associated to COPD by 34%. Medical groups like ChenMed are managing the more complex of Medicare patients with skill and getting great results – with bed days per thousand 40% less than the average. Employers like CalPERS are using their clout to bend their cost curve, reducing knee procedure costs because hospitals are reducing their prices. Real leaders like Joe Fifer of HFMA are pushing hospitals to deploy sensible billing practices and price transparency, building on the success and examples of those that do. And health plans like BCBS of NJ, NC, SC and others are implementing and scaling new payment models, not by dribs and drabs, but with hundreds of procedures. In the face of this actual progress come the teachers who, this week, are telling us that admissions and readmissions might not be preventable – not because they've actually tried it, but because their spreadsheets and PhDs tell them so. Then there's Chip Kahn who agrees that pricing transparency is important, but should be the burden of health plans. Of course, they're outdone by the administrators – those who can't even teach, can't work their ways out of a paper bag, and yet proudly produce useless tools like Physician Compare and actually believe it's better than what the private sector does every day…
What this means to you – With the head chicken gone from the CMMI, let's hope that the new rooster will bring some order to the delusional coop in Baltimore. When you consider the billions spent by CMMI in close to useless initiatives to-date, and contrast that to the few million spent by entrepreneurs to create a spiffy tool like CastLight, there's no question that waste in healthcare isn't simply in the practice of medicine. Of course, the administrators aren't completely at fault because their actions are often guided by the "teachers" – that cult of self-serving hand-wringers who are never satisfied with the results of a study so that they can feed off the public trough to subsidize another study. And when it's not them hitting the brakes, the do-nothing agents of the status quo are all too happy to chime in. So don't be fooled by the headline-grabbing titles of journals that gleefully create a controversy so that they can sell more ad pages to pharmaceutical companies. The real work is happening and generating results, and business people – us common folk, who the teachers often look down on as foolhardy and reckless, and who the administrators scorn because, after all, they are administrators – know what's working when they see it and will transform the industry…. are transforming the industry for the better of all. Because those who can, do.
Francois de Brantes
Health Care Incentives Improvement Institute, Inc.