Envisioning new roles for the health system

It’s obvious that if we’re going to make healthcare a sustainable proposition for the nation, we have to address the elephant in the room—inefficient, high-cost hospital systems that are built and incentivized to maximize reimbursement, not outcomes. One of our core beliefs is that we’re not going to fix that problem without engaging health systems in the work. The notion that we’re going to “disrupt” hospitals and make them “obsolete” is the worst kind of wishful thinking, a David-and-Goliath fantasy that doesn’t us any closer to a real solution. What’s needed are re-envisioned health systems that transform the way they organize and deliver care in a way that drives real value for consumers. Over the next several weeks in this space, we’re going to share one of our core frameworks for working with health systems to advance that goal. We’ll lay it out piece by piece, and then discuss some of the major implications for health system leaders.
We start with a conceptual depiction of the status quo. We describe today’s health system as “Event Health” because most providers are in the business of single-serve interactions with patients, paid on a fee-for-service basis. And indeed, many of the healthcare needs that consumers have present as “events”—acute episodes of illness that can be addressed with a one-time service interaction. For instance, I may have a sinus infection and need treatment, and a single visit to urgent care solves the problem. But across the stages of their lives, consumers have other kinds of health needs as well: some are episodic, with multiple events taking place over a defined time period (think pregnancy and childbirth, joint replacement, heart surgery). And some are just conditions that need to be managed over an extended period (diabetes, depression, cancer). But our health system is a hammer looking for nails—addressing health needs of every type with an event-driven model. Next week, we’ll begin to discuss alternative organizing principles for the health system that moves beyond this “Event Health” approach.


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