There’s an interesting article in the Harvard Business Review that exposes an obstacle to change in healthcare that you may not know about — the fact that doctors feel excluded from the process. Given the amount of time, money and research that is spent trying to figure out why adoption rates of new technology and new business models are so low in healthcare, this is an insight so simple that it might actually be astounding.
The authors of the article, from Bain & Company’s Healthcare practice, said, “After years of experimentation, doctors want evidence that new models for healthcare management, reimbursement, and policy will actually improve clinical outcomes for their patients. Without it, they see little reason to alter the status quo.” Therein lies the rub for any and all initiatives trying to push physicians to value-based care, quality-based incentives or new technology. At the heart of all change lies the physician’s question, “What does this do for my patients?” The Hippocratic Oath is still alive and well.
It’s reassuring to see this information reported directly from the physicians. We have known for a long time that medical technologies can only be successful if they are developed with an inside knowledge of physician practices. Technology that improves practice management, accounts receivable, coding, claims and patient pay cannot be developed in a laboratory beaker. It must be developed hand-in-glove with the people who are going to use the system every day. It must work for the specific needs of physicians who run the practices and agile enough for staff.
The knowledge is there, but not the will
Bain & Company surveyed 980 U.S. physicians in eight specialties, 100 health system finance officers, and 100 health system procurement officers. They found that physicians certainly understand the challenges presented by rising healthcare and prescription drugs costs, however, “… many don’t feel they are in a position to help rein in costs. They do not feel sufficiently engaged in making important decisions about cost control, performance improvement, and adoption of new reimbursement models. Indeed, many feel overruled, with mandate after mandate from hospitals and management-led health organizations being done to them, not with them.” According to the survey:
- More than 70 percent of physicians prefer the fee-for-service model because they are concerned about the complexity and quality of care associated with value-based-payment models.
- 60% of the physicians believe it will become more difficult to deliver high-quality care in the next two years because of a complex regulatory environment, increasing administrative burdens and a more difficult reimbursement landscape.
- Physicians engaged in organizational decision making: 47 percent.
- Physicians not engaged in organization decision making: 61 percent.
Controlling costs for patients
When asked, the majority of physicians said they do feel a responsibility to minimize costs, but not at the system level. Rather, they focus on reducing costs for their patients and helping them to manage out-of-pocket expenses. Physicians realize the importance of reducing healthcare costs for everyone involved in the system but they want to be included on the front line. They want to be asked to help identify which cost-saving approaches are best for their patients. It appears that physicians are tired of being on the tail end of healthcare system decision making.
That brings us back to practice technology that works. Physicians who are sensitive to patient expenses can only help when they have data to work with. That requires accurate, timely insurance verification and preauthorization obtained while the patient is in the office. Only then can patient pay be arranged and the patient engaged in a successful payment plan. Anything less is guesswork.
The world may be moving at lightning speed but responsible physicians are saying “Not so fast.” It’s time we all joined them in slowing down a bit and adopting only the systems and technologies that really truly work.