While there are many successful healthcare models, it's often difficult for organizations to replicate the x-factor due to their cultures or leadership. The secret, then, is to develop new innovation models that don’t hinge on specific cultural and leadership factors, writes Sherry Glied, assistant secretary for planning and evaluation at the Department of Health and Human Services.
Much of the work on innovation must be left in leaders’ hands, Glied writes, citing recent discussions at the Center for Healthcare Management Forum, but policymakers can help significantly by creating a regulatory framework that enables such development.
For example, to stimulate such innovation, policymakers can alter incentives such as capitation or pre-payment. To refocus from the 1 percent of patients that drive most care costs, “policymakers might consider arrangements that would pool a small portion of the risks of the highest cost group through a reinsurance-like scheme, such as the outlier system in the Medicare Diagnosis Related Group program,” she writes. While this would reduce cost-control incentives among high-cost patients, evidence is slim that high-powered incentives make a dent in spending on the most expensive patients, she writes.
Policymakers can also create incentives to drive provider-shopping among patients. For example, under the meaningful use core measure it’s currently up to providers to give patients an electronic copy of their health information upon request, but it would help patient’s care-shopping ability if this were changed to an “opt-out” system, to allow providers to automatically give patients the information unless told not to, Glied writes.
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