Dr. Alan Pitt, a physician and professor at the Neuroradiology Department at Barrow Neurological Institute, is passionate about how technology can play a role in value-based care.
He’s the chief medical information officer at Avizia, Inc., a telemedicine technology provider. He previously won a $100,000 innovation grant from Dignity Health for developing a cloud-based solution for follow-up care. In addition, he was the healthcare representative to the Digital Arizona Council.
He spoke candidly with us about his thoughts on value-based care.
How did value-based care get started?
The U.S. has a major problem. We spend about 18 to 20 percent of our GDP in healthcare. England spends about 9 percent. As a comparison, our outcomes are in the middle — we’re right there with the Czech Republic.
The “fee for service” model was based on hospitals and providers getting paid, no matter what. But the government decided we weren’t getting the outcomes we wanted. So, we wanted to create some way to measure everything. Now, for example, we’re seeing what happens if 1,000 patients have the same knee surgery — and trying to figure out if their results are aligned with national trends. We want a guarantee.
I believe the value-based care model is going to be what will happen next, but right now, it’s just complete chaos — for vendors, hospitals and doctors. It’s like all of our cars have been running on gasoline, but now we have to run on electricity. It changes everything.
What do doctors really think about value-based care?
It depends on who you ask. Some say they love; some say they hate it. But what most doctors can agree on is that healthcare in America is broken.
All doctors are patients. They have families. They want something better. But they’re skeptical the federal government can manage healthcare. Most Americans are capitalists. Our healthcare system is an example of our cultural norms. “I do work; you pay me” — that’s what “fee for service” is all about — that’s capitalism. The Affordable Care Act is not like that.
What role does telehealth play in value-based care?
With telehealth, you’re delivering the right care — and at the right space. A doctor can deliver care to patients at their home, without pushing up the situation to an ER visit. Some people think telehealth is about bringing healthcare to rural communities. But it’s not just about that. It’s about managing a patient’s continuum of care and keeping people out of the ER.
But the problem facing telehealth is that hospitals don’t embrace it. It needs to be fully supported for it to fully work. Right now, hospitals get a big chunk of money from patients going to the ER. If hospitals know they can get money from the ER — why refer patients to going online, if the hospital isn’t incentivized to make money that way?
What’s the biggest issue facing hospital marketers, when it comes to promoting value-based care?
Hospitals believe that they can/should “own” the patient. They tie a financial number to a patient’s life. That’s the DNA of a hospital executive. Patients, of course, don’t see it that way.
As we think about value and the multitude of services hospitals offer, we need to think of new partnerships. Does it make sense to market every service line imaginable? Or does it make sense to partner with a competitor and say: “We won’t build a cancer center and instead, we’ll refer our patients to you. Then, you can refer your patients to our heart center.” Instead of every hospital offering eight tertiary service lines, I’d love to see it if they only offered four — and show that those four are better than everyone else’s.
What advice would you give to marketers who are trying to market value-based care to doctors?
Right now, from a doctor’s perspective, nothing seems clear. Doctors don’t know what they should be doing. If you’re a marketer, you need to send a message that doctors can remember. You need to challenge your C-suite: “What do you want me to tell our doctors?”
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