I was a speaker at the ABIM foundation yearly meeting July 31st. Uwe Rheinhardt and Donald Berwick spoke before me. The following is my reflection on the conversations that followed.
As the nation was hurtling toward a possible default (which was averted thankfully) America's healthcare leaders including Don Berwick, CMS administrator, Peter Lee from the office of health reform, Uwe Reinhardt an economist and Princeton professor, Glenn Hackbarth the chairman of the Medicare Payment Advisory Commission along with dozens of other healthcare leaders throughout the United States were meeting in a retreat sponsored by the American Board of Internal Medicine foundation.
Throughout two days of thoughtful discussions in small groups and during breaks it is my opinion that we really have only two choices in American Healthcare; cut costs by cutting payment or redesign care delivery removing waste and paying for that redesigned care differently. Government accountants are pretty black and white and don't "score" anything from a budget perspective that doesn't involve reducing payments or increasing revenue. I think it is safe to say that most of us favor redesigning care rather than slashing cost but most admit they have no knowledge as to how to do it. Their biggest concern is that it is going to take too long to work.
I was the only presenter who had actual real examples of organizations that had both reduced cost and improved quality. These examples come from the members of the Healthcare Value Network and were published on this site last month (see below).
The ensuing discussions with these leaders have made it absolutely clear to me that building a community of healthcare lean leaders throughout America is really the choice we have to come to. We at the Center for Healthcare Value are committed to helping facilitate the transformation of any healthcare organization in America interested in building a lower cost higher quality system. We have many examples and many teachers in the healthcare industry that have applied the lean principles successfully and we need many more. The alternative? Being paid less and less and eventually being forced to ration care, let's be more proactive than that!
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