Why Can't Healthcare Solve Its Own Problems?
This article appears in the October 2012 issue of HealthLeaders magazine.
In our annual Industry Survey of healthcare leaders, a majority (59%) said too much self-interest among the different stakeholders is the reason that the healthcare industry can't solve its own problems. Only 6% said the industry will be able to find a solution, given more time. What are the greatest opportunities and threats to improvement at the industry level and the organization level?
Marcia Donlon, RN, BSN, MS
Vice President, Medical Center, and CNO
Holy Family Memorial, Manitowoc, Wis.
The enemy within: A quote from Pogo comes to mind, and that is, "We have met the enemy and he is us." My honest answer is, I don't know how we are going to solve this. If any of us had that answer, we'd be rich and have speaking engagements all over the country. For one person, something is an opportunity, and another stakeholder sees that as a threat, and that is where we need to come together. If we don't find ways to build trust and collaborate and sacrifice, we are never going to get there. We can blame whoever we want, but we are all equal stakeholders.
The challenges ahead: Perhaps if we reduce duplication of services and reduce red tape and bureaucracy—whether it is an insurance company or the government, value-based purchasing, core measures—they seem to all have good intent but we get so bottlenecked in all the fine details. Some of it is game-playing. You set rules that are impossible to abide by or to meet the challenges and guidelines that are going to move us forward. Things like the RAC audits, value-based purchasing, and HCAHPS.
Rewarding quality: The idea is awesome. The concept, if it worked, is exactly where we need to go. We get excited to hear about the shift away from fee-for-service with quality and patient safety and outcomes involved here. But then you hear what the rules are and it is almost impossible to do. The other thing is it takes so many resources to meet the requirements that sometimes you ask, "Are we spending more to supply the data and to work on this initiative than we are ever going to get back for it?" Is it going to improve outcomes? Maybe. Maybe not. Some of them haven't been proven to do that.
The shifting political landscape: The other thing is the changing political landscape and healthcare reform. It's so nebulous that nobody knows where to go. Even when we do want to work together, it depends on who is going to be elected. We know the final ruling now on Obamacare, but what is it really going to be after the elections?