CEOs from all health sectors agree: Tear down barriers that hinder quality care
EVANSTON, Ill. — March 2, 2015 — Leaders from health insurance companies, hospital systems and device- and drug-makers may debate loud and often about pricing models, payment methods and patient management, but they agree on one point: The American health care system raises too many obstacles that discourage innovation and undermine properly priced, quality care for patients.
Those barriers include regulations that impede collaboration between providers, payers and manufacturers and data-collection processes that make it nearly impossible to assess the value of a health care intervention (e.g., surgery, a drug or a treatment decision).
That’s the conclusion of 3-month-long qualitative research that global consulting firm ZS will introduce today to drive discussion at a summit with leaders from multiple health industry sectors, government, business, academia and patient advocacy organizations. The Healthcare Leadership Council’s (HLC) National Dialogue for Healthcare Innovation summit in the District of Columbia aims to build consensus on health care payment and delivery approaches that encourage innovation while achieving cost stability and sustainability.
From November 2014 through January 2015, ZS interviewed 51 senior health care executives at 26 HLC member organizations. Participants included leaders from integrated hospital and provider systems, health insurance plans, medical device and biopharmaceutical manufacturers and health care data companies. The consultancy then analyzed the responses, explored ways the industry can deliver value in health care and identified challenges along the way.
“Although participants agree on components of 'value,' they have varying viewpoints on a comprehensive definition – a struggle borne of competing business priorities and financial incentives,” said ZS Principal Bill Coyle. “There are manufacturers who prioritize medical innovation, payers who focus on the cost of those innovations and providers who operate under a fee-for-service model that rewards quantity of care instead of quality of care.
“Along with academic research from the National Opinion Research Center (NORC), our research captures voices of manufacturers, payers and providers and will fuel discussion at today’s summit, encourage future collaboration and, ultimately, turn an industry of competing ‘silos’ into a group of allies.”
Obstacles Prevent Optimal Care
Initiatives under the Affordable Care Act seek to reduce health care costs and improve patient care, but participants told ZS that regulatory challenges, barriers to data collection and sharing and misaligned incentives limit progress.
For example, ZS and NORC noted that federal and state laws – including the antitrust law and Stark Law (federal physician self-referral law) – can hinder various types of patient-focused collaborations.
ZS also reported that most companies struggle with how to collect and utilize health care data in a meaningful way. They disagree on which controls to use or how to measure health outcomes.
“This industry relies heavily on technology to track, measure and disseminate important health information, but it still cannot do so effectively,” said Coyle. “Even so, participants remain optimistic and are willing to work with each other to better improve care quality, control health care costs and inspire innovation.”
Chance to Get It Right
While the nation’s path to a value-based health care system is more an obstacle course than thruway, participating executives identified ways – including innovative delivery and payment models – to a successful journey.
Of the many ideas explored, leaders expressed interest in the following opportunities (among others):
Incentivize payment models that value improvement by linking payment and price to quality delivered;
Improve data collection, system interoperability and data exchange; and
Propose regulatory reform that allows manufacturers to collaborate with payers and providers to demonstrate product quality.
HLC will discuss the above at the summit to spark further national dialogue among those in government, business and the patient community on how to define “value” in health care.
“We live in an exciting era, one in which innovation is transforming all aspects of healthcare,” said HLC President Mary R. Grealy. “The imperative we face – and the purpose of this summit and the work to follow – is to make life-changing innovations accessible to patients within a health care payment and delivery framework that embodies value and is sustainable for the long term.”
For more information, read ZS’s National Dialogue for Healthcare Innovation Research Report here: http://bit.ly/17yJGhn.
ZS is the world’s largest firm focused exclusively on improving business performance through sales and marketing solutions, from customer insights and strategy to analytics, operations and technology. More than 3,000 ZS professionals in 21 offices worldwide draw on deep industry and domain expertise to deliver impact where it matters for clients across multiple industries. To learn more, visit www.zs.com or follow us on Twitter (@ZSAssociates) and LinkedIn.
About Healthcare Leadership Council
The Healthcare Leadership Council (HLC) is a not-for-profit membership organization comprised of chief executives of the nation’s leading healthcare companies and organizations. HLC is committed to advancing a consumer-centered healthcare system that values innovation and provides affordable, accessible, high-quality healthcare to all Americans.