Providers and health plans are locked in a competitive struggle for the upper hand to gain market share and patients. Their focus is not on delivering value or reducing the cost of care – instead, they are focused on shifting the blame for high-cost health insurance somewhere else.
That’s the conclusion of Elizabeth Teisberg, senior institute associate at the Harvard Business School and associate professor at the Darden Graduate School of Business at the University of Virginia. Teisberg is the co-author of “Redefining Health Care: Creating Value-Based Competition on Results.”
Value is not the aim of healthcare in today’s environment, Teisberg said at a meeting of the National Alliance for Health Information Technology in Washington. But, she believes, things can change for the better.
And here’s the clincher. She doesn’t believe that pay-for-performance is the way to change the situation.
“We all agree pay-for-performance is a bad idea,” she said. “What we have now is pay-for-process compliance.”
Teisberg cited the difficulty in keeping measures up to date as one factor that makes P4P ineffective.
Instead of focusing on P4P, she wondered if it would make more sense to address the amount of waste (estimated as high as 50 percent of all U.S. healthcare dollars) already occurring.
A recent informal survey, taken by Teisberg of healthcare experts behind closed doors at the Harvard School of Public Health, revealed unanimous agreement – half of all money spent on healthcare is not spent on actually improving the health of the patient.
More bureaucracy is not the answer – correcting the problem of systemic waste is, Teisberg argues.
In a buzzing hum of P4P discussion in Washington, Teisberg presents a refreshingly different voice. Perhaps she is the one to dare to say the king is wearing no clothes. Perhaps she is merely a dissenter. But either way, she poses something to think about.