Interview with Russ Rudish, Vice Chairman and Health Care Providers Sector Leader
Deloitte & Touche, LLP (New York)
What are your thoughts on the costs of healthcare reform?
A major question is, of course, “where are we going to get the money for reform?’ If history is any guide, becoming more efficient and eliminating fraud and abuse are going to be essential to finding that money. In order to reduce costs, there has to be an “efficiency play” over time, and the medical home model, it seems to me, is going to be crucial. The medical home creates a lower-cost environment. By comparison, the acute care academic medical center is the most expensive environment there is, and one can argue that the fee-for-service payment model is also too expensive. Fixed-payment models will ultimately be implemented because they are more efficient.
Is remote monitoring and preventive care the future of healthcare?
Yes, I think so. It’s more cost-effective and it’s also generational. My father’s generation is quite happy to go to the hospital for care, but my kids never want to go to the hospital. If possible, they’d prefer to consult with a physician online and have prescriptions or tests ordered without ever seeing a physician. The technology companies and the device companies are aware of this and are making major bets that this will happen.
Will there be any pushback if there is a move to a medical home model and away from fee-for service payments?
Yes, I think there may be resistance, perhaps among the medical specialties. “Pushback” may be too strong a word, but there will be challenges. But providers are becoming increasingly competitive. Doctors are desperately trying to maintain their patient base. As a result, patient satisfaction is becoming a big focus. The need to keep patients happy is going to drive changes and reduce physician resistance.