By Jack T. Evjy MD, MMS Senior Medical Advisor

Wednesday, I spoke to the Advisory Committee of the state Health Care Quality and Cost Council about the physicians’ perspectives on the Council’s document, Roadmap to Cost Containment (.pdf).

Here are some of my more salient points:

• Patient centricity is a must. Unfortunately, most recent proposals to improve our health care system are anything but that. They’re insurer-centric, provider-centric, or government-centric – and as such, they inevitably fail.
• Patient centricity begins by making quality and safety the primary focus of any reform effort. Nothing else matters if the care isn’t right, or if it isn’t safe. This includes:
  • Employing an evidence-based approach to care
  • Insisting on coordination and collaboration
  • Addressing unnecessary variation of care, both for underutilization and overutilization

In some proposals making the rounds, patient centricity seems an afterthought. Patient centricity doesn’t guarantee affordability and cost control, but it can’t happen without it.

• With patient centricity as a foundation, other approaches can be addressed. The council’s subcommittee did a commendable job outlining many of these themes and translating them into actionable items. At a conceptual level, we agree with most of them.
• Our sole conceptual quarrel is with the recommendation for tiered provider networks. The measurements and methods currently used to place providers into tiers are faulty to their core. Faulty methods virtually ensure unintended consequences, and I think we’ve seen enough of them over the last two decades to dismiss the prospect of such lightly.

In the end, the right implementation plan will determine success. Concepts or good intentions don’t produce results; actions do. So we will have to pour even more energy and focus into the wise and effective implementation of the recommendation as we applied to their development. Your physicians are committed to being engaged partners in this process.

Filed under: Health Policy, Health Reform, Payment Reform