Opinion: Outcomes, Not Politics, Should Drive the Healthcare Conversation

November 14, 2019
Marc Helberg
Marc Helberg

The way providers talk about healthcare-already one of the most contentious topics in U.S. public life-is sure to change over the next year.

Healthcare has become one of those “just don’t go there” topics in the United States, and this unspoken rule goes way beyond the family dinner table. The divide has become so polarizing that even healthcare providers find it difficult to discuss ways to control costs and improve care. Yet we must. What everyone agrees on-political parties and patients alike-is that healthcare is far too expensive and patient outcomes matter.

So why is healthcare reform so controversial? At its heart, the healthcare argument is a question about rights. On one hand, some believe healthcare is a universal human right that the government is obligated to meet. In fact, more than half of Americans support this idea. On the other hand, some believe healthcare is not a fundamental right; instead, it should be subject to the free market.

It’s easy to get caught up in this political binary and forget the overarching goal: ensuring better, more cost-efficient care and solving problems within the U.S. healthcare system as a whole. Regardless of personal beliefs, the system always has to work for patients, including on a financial level. Otherwise, it’s simply not sustainable.

The outcome perspective

In the current political discussion about healthcare, both sides seem to be missing critical pieces of a broader picture. On the left, there’s no incentive to provide exceptional care. On the right, there’s less benefit for a significant number of patients.

Related: Market Forces That Change How Payers See Healthcare

When having these critical conversations in healthcare, we should remove political variables from the equation and discuss outcomes-based healthcare-not whether healthcare is a fundamental right (and certainly not in terms of dollars).

Moving to an outcomes-based system would control costs for both providers and patients. In turn, it would move the industry forward and improve patient care and financial accountability. An outcomes-based healthcare system would also incentivize practitioners to hit the sweet spot of best possible care and lowered costs. Here, everyone wins.

Canada provides a strong example of how an outcomes-based model can bridge the divide between healthcare that’s universal and financially sustainable. There’s a perception of socialized medicine creating tremendous costs, bloated administrations, and inefficient care that leaves patients waiting months or more for appointments.

That’s true to an extent: Wealthier Canadians do visit the U.S. for care or rely on supplemental private coverage for specialized services. However, Canada is also learning to improve, and the country is doing so by tracking and improving outcomes with data and telemedicine.

Shifting the conversation

To shift the conversation away from an “us versus them” gridlock, healthcare executives must explain how outcomes-based care helps all parties involved.

Parties could argue this in their own ways. On the Republican side, outcomes-based care costs less and results in stronger financials. On the Democratic side (or the universal healthcare side), it unclogs the system. Positive results exist down the line, including healthier people, better working conditions, more workers employed, and more efficient care.

To get there, the industry must become dedicated to tracking and analyzing relevant data. Additionally, healthcare executives should practice sharing data with healthcare providers in the field to help make better-informed patient plans.

Research from Deloitte found that physicians already receive data, but not anything that leads to better outcomes. About two-thirds of physicians regularly receive feedback on their performance and productivity, but only 28% hear anything about costs. This neither incentivizes nor empowers physicians to find lower-cost treatments or testing options for patients.

The saying “you can’t manage what you can’t measure” exists for a reason: It’s true. We’re not providing physicians with any kind of data that will help control costs.

The way we’re talking about healthcare now isn’t working. We’re at a standstill, with one side in direct opposition to the other. By shifting the conversation from healthcare access versus healthcare financials, we can begin to move forward.

Marc Helberg is the managing vice president at the Philadelphia office of Pariveda Solutions, a consulting firm driven to create innovative, growth-oriented, and people-first solutions. Read more about the work Pariveda Solutions does here.