Better Outcomes, Lower Cost

Rewarding higher value care rather than higher volume of care, a stated objective of the new Affordable Care Act payment models, has already begun to drive innovation. Interestingly, this innovation is in patient and provider behavior rather than medical devices or IT, though it’s certainly dependent on the information and analytics IT enables. The outlook for better outcomes at the lowest possible cost, the desired ACA output, looks really good.

These were my conclusions after a fast-paced high-level discussion by experts brought together by the NYC Health Business Leaders last evening. Geraldine McGinty, MD, MBA, a board-certified radiologist at Weill Cornell Medical College, moderated a four-man panel: Richard Frank, MD, PhD, Chief Medical Officer, Siemens Healthcare; Jack Lewin, MD, President and CEO, Cardiovascular Research Foundation; Farzad Mostashari, MD, CEO, Aledade, and Matt Portch, North America Global Innovative Pharmaceuticals Team Leader, Commercial Effectiveness, Pfizer, Inc.

What new behaviors are needed?

For patients, choosing to take more accountability for their own health, to take more of the risk in care costs and pay more, and to take responsibility for shopping for and selecting their own health plans.

For doctors, to be “unfettered advocates for patients,” to engage and educate patients, and to make more efficient decisions based on improved diagnostic information and procedures and in-depth understanding of their patients.

For Big Pharma, to be willing to change, to develop differentiated products, and to price drugs more on value and share risk with customers.

For all providers, to implement EHRs and track drug performance as key factors in pay for performance (P4P).

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