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Last month, healthcare industry futurist Jeff Bauer wrote a guest blog for us, “Bundled Payments: An Innovation Whose Time Has Come?” in which he stated:
“The demise of itemized billing may not happen as fast as some pundits predict, but it will happen. How well it happens can be influenced in a good way by physician leaders who embrace the opportunity to improve health care delivery and population health in the process.”
I thought of this while at Becker’s recent CEO Roundtable where a majority of participants identified bundled payments as an issue that keeps them up at night. Most hospital and group practice CEO’s, as well as COO’s and CFO’s, that I talk to are worried about finances in general and bundled payments in particular. Fundamentally, they are afraid that they won’t be paid enough, that their institutions will spend more than they are reimbursed for in a larger percentage of cases. And who wouldn’t lose sleep over that?
But bundled payments may not be as scary as they seem. As Jeff Bauer noted, they represent an opportunity. It’s all a question of how you look at it. Within the confines of how healthcare is commonly delivered today, bundled payments are indeed threatening. And, in the words of Albert Einstein: “The significant problems we face today cannot be solved at the same level of thinking we were at when we created them.”
So many of the processes and procedures in healthcare, which seem so entrenched, so necessary, so difficult to alter, actually exist to suit the fee-for-service payment model. The idea of taking today’s care delivery processes and retro-fitting a bundled payment model is a pretty scary nightmare. But the idea of figuring out the best way to care for a group of patients, holistically and to their maximum benefit, is more like a dream. And then being paid at the necessary margin above cost, without argument or delay, is like a dream from which you do not wish to wake.
Yet, this is not a pipe dream. A new and better model of care and, subsequently payment for that care, is within reach, given the right perspective and the right leadership. The right perspective is to think in terms of bundled care, rather than bundled payment. The right leadership means involving and relying on the physicians who deliver that care.
When worrying about bundled payments, healthcare executives rarely think of physicians as a potential solution. Too many see physicians as obstacles to change. Nearly two thirds of executives surveyed by Harvard Business Review earlier this year identified cultural resistance or misalignment with physicians as their biggest obstacle to success. One executive was quoted as saying his greatest challenge is “persuading the 59-year-old physician who recognizes that thing are changing but is hoping he or she can hang on.”
No doubt there are physicians, as there are those in all professions, who resist change. But, from my experience working with and training many hundreds of physicians, I can confidently say that they are not the majority. Most of the physicians that I meet, regardless of age, do not want to “hang on.” They want to be part of the solution and look out for the interests of their patients. It is true that they will not happily follow a process or procedure when they don’t see its value. An even greater truth is that physicians are a rich source of ideas and, given the opportunity to contribute, they will lead the way to successful transformation.
Executives need not lose sleep over bundled payments. By engaging physicians and preparing them to lead, they can embrace the opportunity to deliver bundled – or holistic – care. The payments will naturally follow.
The post Physicians Can Lead the Way on Bundled Payments appeared first on CTI.
