This audience has so many sharp business minds. I have been
looking at the “business” model for healthcare, and it seems that it is out of
sync with what most of us have to work with every day.
I have been married to a nurse for 24 years and she has been
a nurse for nearly 30 years (amazing that she is still just 29!). I have had
the opportunity to watch this industry evolve and recently become the center of
the political universe. I want to be clear and state this is NOT about
politics. I wanted to see if I asked all of you really smart business minded
leaders - could we come up with a “cure” for the healthcare industry?
I hope you will share your thoughts in the survey I have
attached at the end of the article. Remember I am looking for business
solutions not political solutions.
The first thing I think about is a clear vision for what
great healthcare looks like. This may be difficult to get agreement on but if
you were the CEO in charge of a healthcare organization, and could make the
changes necessary, what would your vision for healthcare be?
Vision: To
deliver the best healthcare solutions, to the most people, in the most
efficient, and profitable manner. Every patient would receive the most
comprehensive care to achieve a successful outcome.
This is where I think many of us get caught up in the
current paradigm: Health insurance = healthcare. It doesn’t. Health insurance
is a method of paying for healthcare, reducing the risk of being bankrupted by
expensive medical procedures, but it is not healthcare. So put the insurance to
the side and think like a business that delivers healthcare.
The Product: Our
product is providing health services which means we need: doctors, nurses,
facilities, equipment, and the necessary policies, pricing, and delivery models
needed to serve the market. Do we focus on one type of healthcare like
pediatrics, geriatrics, oncology, or a combination of services?
The Market: Our
market is sick people. It is sick people in a specific geographic area, unless
we decide some sort of virtual model which would include the sick people we can
serve virtually.
Delivery: Do we
deliver these services via house call, hospitals, neighborhood clinics,
virtually, or all of the above.
Pricing: Do we
price our products aggressively and target the most patients? Do we focus
specifically on high income customers and price our services higher as to make
better margins?
I started this exercise to demonstrate how I believe most
business oriented people might approach the industry if we utilized a basic
business model.
Could the current
system benefit from a proven business approach?
If we approached healthcare in this manner do you believe we
would see better healthcare? In the current system what has happened are a
number of things that have prevented simple business models to take hold. The
first is the limitation of MD training in this country. The system of training
our future docs limits the number of docs that can be trained, therefore making
their services more expensive. Would increasing the number of doctors improve
the system?
The Price: The
current system is heavily influenced by price charts created by government
agencies. The office of Medicare lists the price they will pay for specific
services. So if a patient has Medicare, doctors can only charge that patient x$
for the service even if that service costs more or less to produce. Would it be
better to price our services according to market conditions? Would that raise
or lower prices?
The Market: The
current practice relies almost exclusively on the health insurance provider.
They set their limitations of payment based on Medicare and prices of premiums,
deductibles etc… If you were the CEO would you accept this insurance or price your
services so that more people could access them even without insurance?
Delivery:
Currently hospitals costs are excessively high due to many factors. Are there
ways to reduce the costs of running a hospital? Why is an aspirin in a hospital
$20 per pill and more? The price includes the additional costs hospitals can’t
charge due to regulation. What could we do to reduce these costs?
Conclusion: I
have just sprinkled a few ideas for you to consider in your solution for the
problems in healthcare. I know this is a very complex issue. Are there simple
solutions? Can we make small changes that will make a big difference quickly? I
am interested in hearing from you. Do you see ways to apply business practices
to the current healthcare system to improve services and bring down costs?
Can we do healthcare more effectively through a market based
business model or is the government better suited for delivering quality
services at lower costs? Is there a combination that works best?
I believe there is a business solution here. I also know
that there are self-interested parties that may be protecting their “markets”
as well. But what if magically we had the power for a short time to create a
better model without injecting politics? Could we succeed?
I believe this audience and most business people if given
the mission to fix the system would be able to do it with proven business
practices. The caveat is that we would have to keep politicians a million miles
away from the process. But I want to hear from you: Is there a business “cure”
for our healthcare system or am I just wearing rose colored glasses? Take the survey…
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