Moving forward after healthcare reform

CHICAGO—Lawmakers, policymakers, consultants and hospital CEOs spend plenty of time talking about healthcare reimbursement, quality of care, individual mandates, etc. But lofty discussions aside, make no mistake about it: The changes to our healthcare system will affect supply chain executives. They already are.

Peggy Naas, MD, MBA, vice president, physician strategies for VHA, made the point in her presentation, “Moving Forward After Reform: New Foundations, New Frontiers,” at the recent Healthcare Supplier/Provider Institute conference. Founded in 2004, the Institute strives to enhance provider/supplier effectiveness in the healthcare market. Following are some highlights from Naas’s presentation.

The federal government has made a decision to reimburse providers only for appropriate, clinically effective care. Consequently, the feds have invested a lot of money in comparative effectiveness research, trying to devise ways to determine what technologies and processes really work, and which don’t.

The healthcare reform law has set a high bar for providers, who are expected to provide affordable care with quality outcomes. A national strategy is now in place to improve healthcare quality. “These are not modest words,” said Naas.

The end result will be new patient care delivery models, all of which will require a different level of collaboration between physicians, health systems and others, she said. Look for such things as gainsharing, medical homes, shared savings programs, and risk/reward programs for reductions in hospital readmissions and hospital-acquired infections.

To help providers meet these goals, suppliers will have to position their offerings in terms of how much value they add. Suppliers should also prepare themselves for accountable care organizations, with their promise of shared savings but also penalties for failing to achieve quality and cost goals, she said. Providers may demand that suppliers be held accountable for the outcomes their technologies bring about.

Physicians have already gotten acclimated to this new world, said Naas. Reports on the quality of their care are already published on the Internet, and documentation of how many resources (in dollars) they consume to deliver their services will also be a matter of public record at some point. “We’re already seeing pressure in the commercial sector for primary care providers to refer to the most cost-effective and value-effective specialists,” pointed out Naas. “This may change the perceptions of the orthopedist, cardiologist and other [specialists] on the cost to deliver services.”

To survive, hospitals and physicians will have to build a strategy around clinical integration. But that won’t be easy. “Unfortunately, true shared governance does not come naturally to hospitals and health systems, so there will be a little bit of a rub going forward,” said Naas. And whether the healthcare reform law is ultimately struck down or not has limited influence on the industry at large. “The commercial markets are not standing still,” she said.