Pacing Change to a Tolerable Level

Recently I read an interview of David Cutler, PhD, Harvard University, and a senior white house health care advisor, with Richard Clark, president and CEO of Health Care Financial Management Association in the Healthcare Financial Management Journal. The interview talked about payment reform as evolutionary not revolutionary, and was insightful on how to achieve cost savings in health care through payment reform. Too bad there isn’t a better way to get to payment reform than through trial and error.

Pacing the rate of change toward a new payment system is going to be critical for most organizations. The recent turmoil of the 2008–2009 economic downturn has resulted in significant change for most health care organizations. Add to these changes the electronic health information exchange initiatives and the large numbers of organizations who are scrambling to integrate with physicians and you have senior management teams with a lot on their plates. With a shift to bundled reimbursement or value-based purchasing many leaders may find their organizations are on overload.

During the 1990s when mergers between hospitals and integration with physicians were occurring to create the integrated health system, Modern Healthcare magazine ran an article asking whether our health care organizations were clinically depressed. The article was really fascinating and for many of us working in hospitals, long-term care or home care settings, and physician clinics, we would have said we were approaching a catatonic state some days. My prediction is that if we do not begin the transitions required for new payment reform, regardless of what form it takes, the amount of work and the timeline to accomplish it all with too few resources will undo us all. Taking a wait and see attitude for most organizations will not be a great strategy. What’s your prediction?