With the debate about whether or not all people should have healthcare coverage behind us, the puzzle to figure out is how to fix the broken healthcare delivery system. Monday’s keynote speaker at the Healthcare Financial Management Association’s annual ANI conference offered a solution.
At the core of fixing the broken healthcare delivery system is finance people working with clinicians, and the language to span the differences is data, said Atul Gawande, MD, a physician leader and author of a number of books, including Better: A Surgeon’s Notes on Performance.
“We’re just starting to discover what happens when you put you and I and other people like me together and it’s a pretty stunning thing,” he said.
For instance, he said, while the industry has known for a long time that 5 percent of patients account for about half of healthcare spending, what that information means has been “miscalculated.”
“I think the reason why we’ve miscalculated what it has meant because the people who know the 50 percent of the costs are different from the people who know the 5 percent who are the sickest,” he said. “I’m on the clinical side, and I see those sick people. But you understand the money and what it means, are the ones who see the 50 percent of the costs, and we don’t talk.”
While clinicians are still adapting to working in teams and both clinicians and finance administrators are trying to cross the administrative-clinical divide, the most important resource the two groups have is data.
Financial administrators and clinicians can dig down into patient data to see why a patient is costly. Most of the time, Gawande said, the sickest patients are those who are receiving the worst care, and the poor care results in outcomes that are costly, both in terms of dollars and patient health. Seeing the relationship between sickness and cost is the key to better care and lower costs, he said.
“It’s still about the sickest,” he said. “It’s about what we do and whether our systems work for the people that are suffering most in our society. Your job is the same as mine and that’s to reduce the harm and suffering. That’s how we fix healthcare.”