A money manager of a large fund mutual fund recently told me, “The words ‘Tax Reform’ simply mean that politicians want to take more money from someone.” This explanation of Tax Reform lead me to ponder exactly what do the words ‘Healthcare Reform’ mean? Applying the money manager’s logic, Healthcare Reform simply means the politicians want to take money from somone in healthcare. Ostensibly, this Heatlhcare Reform is presented under the guise of decreasing costs, but still the monies representing the decreased costs are coming out of someone’s pocket.
So, whose pocket is the money being taken from, you might ask? Healthcare providers........physicians and hospitals! How do I know? Because the “reform” of the payment model from fee-for-service (FFS) to value-based-purchasing (VBP) only affects the providers of healthcare. Medical insurance companies, unions and other large purchasers of health insurance have gotten off scott free.
As I wrote in my first blog (click here to read), the business of healthcare is like a crossword puzzle with an ever- changing set of rules. Now that CMS has revealed the new rules or the details of the value-based-payment model, providers can adapt and thrive in the current wave of healthcare reform. How? By understanding the critical business tenets that are the foundation of the VBP payment model and adapting their business to execute fully on these imperatives.
The four tenets that providers and their businesses must flawlessly execute are successful patient outcomes, patient safety, system efficiencies and quality of care. With CMS skimming off the top 1% (growing to 2% in 2017) of a provider’s total yearly reimbursement and only paying it back if certain outcome metrics are satisfied, the argument can be made that patient outcomes is the most critical driver to your business. Driving the point home even further is that private insurers are marching in lock step with CMS. UnitedHealth Group, Aetna, and Wellpoint recently announced they are switching to a VBP payment model. 1 (Click here to read an earlier blog predicting private insurers following CMS’s initiatives).
The more a patient trusts his or her physician, the more successful will be the patient’s medical outcome.2 To gain a patient’s trust, a physician must establish the following: an acitve communication style that values the patient, the capability to display empathy and emotional support for the patient and view the patient as a “whole” person.
Executive business coaching of physicians results in patients trusting their physicians.2,3 To thrive in Healthcare Reform, it’s time to partner with a certified executive business coach experienced in healthcare to keep the money in your pocket!
_____________________________________________________________________________________________1. New Way to Pay Doctors, Anna Wilde Mathews, The Wall Street Journal, Section B, page 1-2, Feb. 9, 2012, S
2. Cassatly M, Coaching the Patient-Physician Relationship: A Successful Approach to Lower Healthcare Costs with Improved Medical Outcomes, J of Medical Practice Management, Vol 25:4, 229-233, Jan/Feb 2010
3. Cassatly M, Bergquist W, The Broken Covenant in US Healthcare, J of Medical Practice Management, Vol 27:3, 136-139, Nov/Dec 2011
