He may have been preaching to the choir, but surgeon and thought leader Atul Gawande, MD, told a crowd at the Healthcare Financial Management Association’s annual meeting in Las Vegas that data and leadership from healthcare finance experts will have the biggest impact on improving the value of healthcare.
Reminding attendees that the sickest 5 percent of patients account for 50% of healthcare costs, Gawande said providers and payors must find new ways to interact with those patients. That process of discovery necessarily will entail trial and error, as healthcare providers make the shift from fee for service to value-based care.
Research by Gawande published last year underscored the challenges inherent in the transition: Texas Health Resources’ surgical profits increased 330 percent when there was a surgical complication, because payors pay for the fix.
As a result, the hospital negotiated a deal with payors that would maintain payments if complications were reduced, and not only me but exceeded the goal of a 10 percent reduction in complications. Be on the lookout for the final financial figures expected later this summer that will reveal whether the experiment was a success for both parties.