Newtown, CT – June 12, 2015
When professionalism is freed from the tyranny of bad incentives, a remarkable transformation takes place.
"Having nurses and other disciplines working together and keeping the patient at that center of our focus is often only spoken in words. However, this project has truly taken the words and put them to work. We are working with outpatient therapy, skilled nursing centers, home care, and hospitals in a collaborative effort. We have common meetings to be on the same page, with the same vision, and the same goals. I can assure you this is a first!
This project has been an incredible journey and has us looking at process improvement in a whole new way. It certainly has benefited each of us involved in the project but most importantly the patients. I have received positive feedback from so many, and I am thrilled to be connected to so many patients and the healthcare network in a whole new way." Becky Kelley, R.N.
What this means to you – The change that we want to see happen, that we talk about and hope for, is being realized in pockets across the country. Our premise has been, and continues to be, that if you design payment programs that minimize bad incentives and put the whole focus on optimizing care for the patient, around medical episodes, and with appropriate upstream and downstream accountability, the front line clinicians quickly and irrevocably move from the doldrums of every day life in a practice, to the energized, idealized professionals they want to be and have trained for. And it does happen quickly. We started this bundled payment pilot in January, barely five months ago, through the leadership of the Pennsylvania Employee Benefits Trust Fund and its Executive Director, Kate Farley. It took a couple of months to get the processes for data collection and reporting in place, to understand how budgets would be set, why the clinical data being collected was essential for the quality scorecard, and then we were off. In March the first set of data were collected, and with it the realization that there were some gaps. And from that point on, the transformation was launched. This simple, easy concept of a feedback loop at the locus of control has never failed to work its magic, as long as the professional is freed from worrying that a good deed will go punished. As I've written many times before, it's hard to be good when you're encouraged to be bad, but it's also incredibly easy for professionals to shine when they're not encouraged to be bad. And that's why the design decisions that payers make in putting together their payment reform efforts are so important. If you get it wrong, the reform will fail, not because the payment model is inherently wrong, but simply because the design of that model was bad. And when you do it right, you unleash the professionalism of Becky and all the other caring and wonderful clinicians that make up the bulk of the industry's workforce. So for the sake of all, get it right, and then step back, watch, and smile.