Why should the health care business model “incentivize good care”?
To remove the reward for bad outcomes. We’ve got 1.7 million hospital infections and a C-section rate quadruple anywhere else in the world. Those are totally driven by a poor business model.
You tout the benefits of prepayment in ACOs (accountable care organizations). Why?
People once thought that whatever care prices they were given were the right ones. A cash flow will give you more leeway to provide better care without incentivizing reentry.
Isn’t there also a tighter rein on performance?
Hospitals are forced to report infection rates. There’s a standard of care – and an increasing sense that performance problems exist relative to surgeries, outcomes, and mistakes.
Won’t there be a consumer backlash against ACOs?
An ACO takes someone who needs team care and makes sure they get it. The early backlash against HMOs in the ‘90s was due to [too many] admissions screens. That model went too far.
Tell us why walking will reduce health care costs.
We must incorporate physical activity into the budget longterm to save Medicare. Diabetes is 32 percent of the cost. If we cut it in half, the projections of when the Medicare trust fund runs out would be extended by half a century.