It is as natural for doctors, hospitals, health plans and others to aggressively affirm their “patient-centeredness” as it is for politicians to loudly proclaim their fealty to the hard-working American middle class. Like the politicians, the health care professionals no doubt believe every word they say.
The most accurate measure of “patient-centered” care, however, lies not in intentions but implementation. Ask one simple question – what effect does this policy have on patients’ ability to control their own lives? – and you start to separate the revolutionary from the repackaged. “A reform is a correction of abuses,” the 19th-century British Parliament member Edward Bulwer-Lytton noted. “A revolution is a transfer of power.”
With that in mind, which purportedly patient-centric policy proposals portend a true power shift, and which are flying a false flag?
Falling Short Of Shifting Power
The two most prominent examples of initiatives whose names suggest power sharing but whose reality is quite different are so-called “consumer-driven health plans” (CDHP) and the “patient-centered medical home” (PCMH). Both may be worthy policies on their merits, but their names are public relations spin designed to put a more attractive public face on “defined contribution health insurance” and “increased primary-care reimbursement.
Let’s face it, as a startup in the health care space, it’s not easy to land a first pilot to demonstrate the value your new technology, much less get paid for one. Strict federal regulations, billion dollar EMR implementations, and the fear of privacy leaks have made our nation’s providers very risk averse and extremely cautious about working with early stage health tech companies. Implementing new technologies in hospitals, where there are strict IT guidelines relating to ensuring patient data privacy and heavy bureaucracy, is difficult. Large hospital systems and other health care service organizations simply do not have the bandwidth or resources to guide companies through these challenges and therefore are reluctant to partner with early stage companies.
One of the many challenges I face in my clinical work is keeping track of a patient’s multiple health issues, and staying on top of the plan for each issue.
Same story, different week: A governor who opposed the Affordable Care Act changes course and announces plans to opt into the Medicaid expansion.
