I Saw the Future of Health Care Last Week

Thursday, April 14, 2016 | Larry Sobal

Last week, a few hundred physicians and administrative leaders came together for MedAxiom's CV Transforum Spring '16 conference. What I feel makes these meetings unique is the format, where leaders openly share their innovations, purely with the goal of allowing attendees to learn about their successes and the journey it took to get there. The conference offered detailed examples that attendees could take back and incorporate, or innovate, to their advantage in their organizations.

I want to share a sample of some of the topics covered, as they offered fascinating glimpses into where health care is heading in the future.

Richard McCarthy, physician in chief at Kaiser Permanente for the Mid-Atlantic States, shared how Kaiser incorporates a fully-integrated delivery system, a prepayment model, advanced information technology and evidenced-based organization of care delivery, to achieve remarkable performance. What impressed me most about Dr. McCarthy's talk is that he may be the first health care leader to offer quantitative evidence of achieving the Quadruple Aim of healthcare—namely superior care--at lower costs, with a high-performing patient experience. And all of this being achieved with very high satisfaction amongst physicians.

Roger Strode, an attorney and partner in the Chicago law firm of Foley and Lardner, offered his insights into the evolving legal and legislative environment in health care. What excited me the most about Roger's talk was his opinion that legislators are recognizing the maddening conflicts between certain pieces of legislation. Specific examples involve the prohibitive rules within the Stark Law that stand in the way of physicians and hospitals working together to innovate care delivery and become more efficient. At the same time, various CMS-led initiatives are incentivizing both parties to do just that. If this conflict can be removed, or at least lessened, then many of the innovations that organizations want to make will become much easier.

Drs. Ben Bache-Wiig and Craig Strauss, both from the Minneapolis Heart Institute, shared how their organization is using a data warehouse to provide physician-led teams with accurate and timely data, showing very specific variations in care and use of resources. I have always found physicians very interested and willing to change their approach, if valid information demonstrates how they can do better. The problem, as we all know, is that good data is hard to come by in an industry that lacks the interoperability to pull all the critical data pieces together.  They are doing just that in Minneapolis with remarkable improvements.

Dr. Rick McClure, from the University of Kentucky, and Barry Wyant, from Marshall University, addressed how academic and community medicine--which can often be at odds with each other—can successfully collaborate to leverage their respective missions and expertise. The reality is that we need to have strong academic programs, which continue to teach and train physicians, as well as conduct research. And we need to have strong community practices that work together to offer health care in the right setting by the right person. While financial pressures can potentially cause them to become acute competitors, wise programs such as these recognize the value of cooperation and sharing of resources.

Dr. Xiadyan Huang, from Providence Health System in Portland, Oregon, shared her organization's journey to become the first practice in the country to implement and attain designation from NCQA as a Patient Centered Specialty Practice (PCSP). We are all probably familiar with the primary care-based Patient Centered Medical Home model. What's exciting about the PCSP approach is its focus on creating a collaborative “Medical Neighborhood” model, where primary care and specialty care share accountability for the cost and quality of care for patients, as they receive services across the continuum of care (as opposed to gatekeeper models that place that burden solely on primary care). Adopting a PCSP approach also has the benefit of closely aligning organizations with the upcoming MACRA requirements, regarding managing populations in a value-based reimbursement setting.

Dr. David Wolinsky, from the Cleveland Clinic Weston Florida, shared his insights into the current status of the 2014 Protecting Access to Medicare Act (PAMA). While the starting date has not yet been defined by CMS, it will require physicians who order advanced imaging studies to consult Appropriate Use Criteria, using a decision support tool, before reimbursement can occur. Although AUC is still an emerging science and decision support tools are still in various stages of maturity, the initial data from SMARTcare and its use of clinician-driven data, benchmarks, and analytics with feedback, does have a positive impact on reducing inappropriate ordering of tests. It will be exciting to see this part of the health care industry evolve. 

These were among many fantastic sessions, where presenters offered the gifts of their knowledge, experiences, stories of success, and shared learnings along the way. All with open encouragement for attendees to use this information to innovate in their organizations and take the idea to another level.

Finally, what may have provided the best insight into the future of health care, was the flow of informal conversations among attendees. Their attitudes were overwhelmingly positive, in terms of their awareness, preparation and readiness for change. That gives me great hope for how health care is being reformed from the inside—by great leaders with a passion for transformation.

If you want to experience a similar epiphany about the future of health care, then register for the MedAxiom Cardiovascular Service Line Symposium, being held June 9-11, in Washington, D.C.  You can find more details and register at CVSL16.com.

 

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Larry Sobal is Executive Vice President of Business Development at MedAxiom. He has a 35-year background as a senior executive in medical group leadership, hospital leadership and insurance. As part of his current role, Larry consults, writes and presents on topics relevant to transforming physician practices and health systems.

 

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