5 Ways Doctors Can Enable Value-Based Care in 2020 and Beyond
Technology in healthcare gets a lot of press, so I wasn’t surprised to read 5 Ways Technology Will Enable Value-Based Care in 2020 and Beyond in Forbes. In the weeks since, my thoughts kept returning to the article until I had an epiphany. The article’s author, Joe Harpaz, calls out a good list of meaningful technologies, but they won’t deliver what we’re hoping for – at least not without the best, and true enabler of value-based care: Physician Leaders.
I’m no luddite. I love technology. I run a company that has bet big on its own application development and data analytics groups. But technology has its limitations. It can be world-changing when it solves a problem people want to solve. Otherwise, value-based care enabling technologies will have about the same impact as Match.com, Tinder, and other dating apps have on monks. Doctors need to shift their mindset. There are five crucial steps physician leaders must take to make the shift, and truly enable value-based care.
Making The Shift To Value-Based Care
1. Choose to Get Paid the Right Way – Full-Risk Capitation. Everything flows from the incentive system. When the system pays for volume, we get volume. When the system pays for value, we get value. Change the incentives and we change the mindset. Physicians are smart and do not like to fail. They can and will adapt to the system built around them. They just can’t balance optimizing for volume and value at the same time. No one can.
2. Embrace Coaching. It feels amazing to perform a heroic intervention and save a life. But the real heroism in healthcare lies in our ability to impact health and longevity through changes to lifestyle and behavior. Being a PCP means being part-time nutritionist, therapist, social worker, trainer and friend. Physicians must build trusting relationships so we can convince people to make healthier choices.
3. Commit to Pride in Primary Care. All too often the subspecialists occupy the top spots in the physician pecking order because they bring big bucks into hospitals. The real hierarchy, however, should put the Primary Care Physician (PCP) on top. When PCPs act like the “bosses” they are and bring in the subspecialists to fulfill a specific need, overall value and well-being improves.
4. Talk to Each Other. Value-based care relies on a holistic picture of a patient’s health and medical treatment. But there are low-tech solutions. Have more hallway conversations, “phone a friend”, or use a HIPAA-compliant messaging/chat service. The more physicians communicate, the more they can use the information we already have to make better decisions that lower cost and improve outcomes.
5. Be Humble. We learned a lot in medical school; but not everything. Nurses, medical assistants, case managers and family members know things about our patients that we may not. The office staff knows more about service and operations and finance. Physicians must be humble enough to learn from others – all while retaining direct accountability for the patient’s experience, health outcomes, and affordability.
Yes, it’s a big shift to embrace value, but we don’t have a choice. We pay more than any other nation for healthcare and we get very little to show for it. Costs are rising as life expectancy falls. The situation is even more acute in lower-income neighborhoods where we operate. It’s no wonder we spend nearly a year and vast sums of money helping newly hired physicians at ChenMed unlearn the broken constructs of fee-for-service medicine in favor of our value-based model. We’ll gladly adopt new technology that makes value-based care easier; but the real enablers will always be physician leaders.
