October 31st, 2012
Faced with the alarming implications of health care spending growth and suboptimal quality, many nations are turning to market-based reforms. The United Kingdom recently empowered primary care physician groups to choose among competing specialty care providers for their patients. In the United States, payers are introducing tiered copays, making patients pay more to visit what payers deem high-cost or low-quality providers. Even Sweden has introduced choice and competition in areas such as knee replacement and spinal surgery to curb the tide of rising costs.
The rationale behind these reforms is compelling and age-old: competition will unleash innovation, lower costs, and boost quality. But in health care, this logic hasn’t held, and largely for one simple reason: we do a terrible job of measuring, disclosing, and competing on the things patients actually care about: their survival, quality of life, and rates of complications after care.
Beneficial competition is rooted in informed choice. For competition to achieve its promise of incentivizing higher-value health care, patients and payers must first be able to determine and elect higher value options — providers who deliver better outcomes at the same or lower costs. Providers, meanwhile, must be able to benchmark their own performance against peers to find and adopt innovations that deliver improved outcomes for patients.Read the rest of this entry »