Putting the “Care” Back in Healthcare

When it comes to specialty care, America has the world’s most advanced medical system. Yet compared with the rest of the developed world, our health as a country is mediocre at best, despite all that we pay for it.

Most of us are familiar with this in one form or another – maybe we’ve waited for hours in the emergency room or bounced from doctor to doctor looking for the right diagnosis or treatment. Maybe we’re able to find the help we need to get better but not to stay better. Or maybe we’ve been frustrated when our doctors can’t see us for more than five minutes at a time.

One reason America lags behind in health care is no doubt due to the difficulty that many people have getting and paying for health insurance. But our fee-for-service system—in which providers are paid by volume instead of by outcome—incentivizes quantity over quality, and often leaves us with substandard care at a hefty price.

Although attempts to change this were underway even before the Affordable Care Act (ACA) was passed in 2010, the healthcare reform bill gave new energy to these and other efforts and has already begun changing how many of us receive our medical care.

One example of this is the Comprehensive Primary Care Initiative. While many of us are used to seeing different doctors at different times for different symptoms, primary care physicians in this program work together with other providers to provide more coordinated care for their patients. They’re also able to offer more patient-centered care through personalized care plans, preventive health services, and by engaging patients and their families in their own care.

Another set of quality improvements in the healthcare reform bill center around reducing medical errors in hospitals, including hospital-acquired infections, medication errors, patient falls, and diagnostic mistakes. Astoundingly, thousands of Americans die each year due to these preventable mistakes, and many more are temporarily or permanently injured. The Center for Medicare and Medicaid Services estimates that these efforts can “save 60,000 lives and reduce millions of preventable injuries and complications in patient care over the next three years and save up to $50 billion over 10 years.”

We’ll also be seeing more Accountable Care Organizations (ACOs) as a result of the Affordable Care Act. In an ACO, providers coordinate patient treatment and then get to share in the savings if they improve medical care while keeping costs in check. The main categories of measures by which ACOs are judged are patient experience, care coordination and patient safety, preventive health, and at-risk populations. In other words, we’ll find that quality of care is increasingly what matters in our healthcare system.

These changes won’t happen overnight, but over the next few years the Affordable Care Act may well have as big a change on the type of care we receive as on our ability to get it.

Contributed by: Marcus Denton, Austin, Texas