Nine out of 10 healthcare opinion leaders think fundamental change is required to achieve gains in quality and efficiency of care in the United States, according to the most recent Commonwealth Fund/Modern Healthcare survey.
The 14th Health Care Opinion Leaders Survey, conducted in March, asked a diverse group of 211 experts for their perspectives on healthcare delivery system reform.
"True reform identifies core flaws and targets those flaws. In the U.S., the fundamental flaw in health care isn't access (which clearly must expand) or insurance (which must become more affordable)," said Gregory P. Poulsen, senior vice president of Intermountain Healthcare and a member of the Commonwealth Fund Commission on a High Performance Health System, in a commentary on the survey. "It's more complicated, more systemic. And only by addressing the core issues of cost, structure and the need to align incentives around value-enhancing quality can we ever hope to make the system functional, accessible, and affordable.
When polled about specific strategies for improving the system, a large majority of healthcare leaders said strengthening primary care (90 percent), encouraging care coordination and the management of care transitions (90 percent) and promoting care management of complex patients (88 percent) were very important or important to improving health system performance. Opinion leaders also cite payment reform as an important strategy to enhance primary care physicians' ability to provide coordinated, high-quality care, as well as to help prevent costly hospitalizations.
"Although universal coverage is a prerequisite for a high performance health system, coverage needs to be coupled with care that is accessible and well coordinated," said Commonwealth Fund President Karen Davis. "The majority of healthcare opinion leaders believe that our delivery system is broken, but fortunately there are ways to ensure that all Americans have patient-centered practices accountable for their care.
According to the survey, seven out of 10 healthcare opinion leaders agree that medical homes are more likely to deliver patient-centered care, but half think the growth of retail clinics is a positive development. And a majority of those support coordinating care from retail clinics with regular care.