Stop Paying for Procedures, Start Rewarding Outcomes

Outside of the fact that both are located in the Kansas City area, it’s hard to imagine two businesses more dissimilar than Cerner Corp. and Truman Medical Centers.

The former is an entrepreneurial, international health care IT company founded a little more than 30 years ago. The latter is a two-hospital, urban safety-net system that traces its roots back to the middle of the 19th century.

That’s what made a 24-hour span last week all the more fascinating.

In completely separate venues, I heard executives from both organizations say the same thing, almost verbatim.

The gist, from Truman CEO John Bluford and Cerner Senior Vice President Dick Flanigan, was that the U.S. health care system must transition from paying for procedures to rewarding positive outcomes.

Bluford made the point in Wednesday testimony to a Missouri Medicaid reform working group.

Viewed strictly from a revenue standpoint, Bluford said, Truman is shooting itself in the foot by stressing patient wellness. Under the current fee-for-service model, he said, it doesn’t pay to keep people out of the hospital.

The next morning, in opening a Population Health Summit organized by Cerner, Flanigan came at the issue from a different direction. One of the main themes of the conference was using the abundance of health IT data to improve the efficiency of the system.

“Population health is not about the things we do to people,” Flanigan said. “It’s the things we do with people. It’s the things we together accomplish to improve health. Now the problem is: how do you get paid for that?”

Truman is a Cerner client, so in that respect, the organizations share more in common than first meets the eye.

Also, the comments by Bluford and Flanigan were hardly revolutionary. Barely a day goes that I don’t read or hear those sentiments expressed in some form or fashion.

As a matter of fact, using care coordination to drive down health care costs was at the core of an event I covered Tuesday.

I don’t know if there’s a grand takeaway from all of this, but these various conversations do inspire hope.

Perhaps with everyone rowing in the same direction, the U.S. can improve population health at the same time it decreases health care spending.

Health care is a complex endeavor, no matter if it’s a government-run enterprise or it’s a public-private system like we have.

At this meeting I covered Tuesday, organizers brought in a futurist to set the stage for the day. I won’t go into details here – that’s for a future post.

But one of his points was not to let the events of yesterday constrain your dreams for tomorrow.

The future, he said, “can transcend anything you have known from the past.”


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HCF's Local Health Buzz Blog aims to discuss health and health policy issues that impact the uninsured and underserved in our service area. To submit a blog, please contact HCF Communications Officers, Jennifer Sykes, at jsykes@hcfgkc.org.

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