CEO: Hospitals Should be 'Like the Maytag Repair Man'
That doesn't mean there aren't future issues to iron out in such a partnership. Outcomes need work, Weiss says, but they're attacking processes first. "This is not rocket science."
To learn how to do this right, Weiss says, the open-ended collaboration with Blue Cross Blue Shield allows for limited downside risk for not meeting its targets, he says, which are multiple.
"One good thing about this relationship is that with limited downside risk, it's like learning day at the casino," he says. "We're playing cards, but in a sense, we're not playing for real money. Later, it's the real deal. Right now, we don't have a downside risk."
Except that keeping people out of the hospital has its own serious costs.
With other payers, a hospital visit can be lucrative, as it can be with Medicare, as long as its limited quality targets, such as preventing 30-day readmissions for the same condition, are met. As the relationship develops with Florida Blue Cross Blue Shield and other payers—"This is not a monogamous relationship. We are going to get better at this," Weiss says—he hopes that payers will recognize a need to share their profit margin with providers.
"We have to get Florida Blue and others to understand if we can keep everyone healthy, they need to share with us their profit margin," Weiss says.
"If we can get to that point we have it made. We'll be like the Maytag repair guy, which gets them away from paying us for sickness. That's the tragedy of the current system. We can't afford to continue to do what we've done."
Philip Betbeze is senior leadership editor with HealthLeaders Media.
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