by
Sean Ruck, Contributing Editor | June 10, 2015
From the May 2015 issue of HealthCare Business News magazine
It’s easier said than done though. From what he’s seen, Kimball doesn’t believe that medical schools are shifting gears to help the health care professionals of tomorrow develop the proper mindset to make the change that’s needed. “They’re all being trained about how to fix sick people. There’s very little discussion about preventive medicine. In some ways, it’s culturally conflicting for doctors in hospitals, because they’re designed to be manufacturing plants to treat disease rather than prevent.
There’s been quite a separation from the medical world to the public health world.” Conversely, most medical professionals have the knowledge to make the value-based care shift, at least in theory. “It’s telling that 65 percent of Americans die in an institutional setting – hospital, nursing home or hospice, yet only 7 percent of doctors do,” says Kimball. If done right, while it may be painful at least at the start, with downsizing likely necessary, hospitals that survive and react intelligently could experience significant growth to their bottom line. “Right now, hospitals average a 56 percent bed occupancy rate.
If volumes come down by 20 to 30 percent we would have an even greater oversupply of hospital beds than we do now. And the health care industry is supply driven. Oversupply will drive more demand.” Kimball cautions that there is a potential negative that requires monitoring. “There’s a real risk here of the provider group denying care to some patient groups in order to maintain profitability. There’s a risk that some may cut corners to deliver profits and ultimately end up with worse outcomes.”
We’re currently at a tipping point Kimball says. “I think we have better data than we’ve had in the past and a better ability to understand it. I think that the ACA has put out the concept of value-based reimbursement that people have rallied around. I think it’s a start and in the next few years we’ll see innovations at Medicare for new reimbursement models. I think patients are going to demand something different and transparency in the market place will help that. Because we’re already doing this in pockets around the country, we know there’s value in this move to value-based reimbursement. I think it will take 10 or 20 years to change the system. I think it will take entrepreneurs to shake up the system. Hospitals will not do it all on their own.
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