Reform to fundamentally change healthcare business model

Hospitals, insurers and physicians will have to make fundamental changes to their business model in a post-reform operating environment, according to a new report by the venture capital firm the Psilos Group, reports Healthcare Finance News.

The report concludes that one of the consequences of the Patient Protection and Affordable Care Act is that it will create a market-based healthcare system that will require hospitals, health plans and doctors to provide "value-based performance"--essentially better outcomes at good prices.

"If you are an employee and you now are being given a chunk of change to go buy a plan on your own, you're going to look for the kinds of things you look for when you buy a car: friendly salesperson, quality service, 'I understand what's happening'--the paperwork and all that," said Lisa Suennen, co-founder of the Psilos Group and one of the co-authors of the report.

In addition to the payer equation becoming more in line with consumer expectations, Suennen said that hospitals will have to implement more comprehensive care planning because they won't get paid for many readmissions and will be penalized for medical errors.

However, consumers will also have to educate themselves about the healthcare system and "take ownership of the process," Suennen added.

For more information:
- read the Healthcare Finance News article
- read the report