Dr. Atul Gawande was named CEO of the new Amazon, Berkshire Hathaway and JP Morgan Chase healthcare partnership earlier this year. Many of you may already be familiar with Dr. Gawande. He is a Harvard surgeon, a public health researcher and the author of several New York Times bestselling books.
Over the years, the Compass Navigating Healthcare Blog has published many posts about Dr. Gawande’s work. Below is a summary of three of those posts:
1. Famous Surgeon Atul Gawande Publishes Study in JAMA: Hospitals Make Higher Margins When Surgery Has Complications
Dr. Gawande studied a 12-hospital healthcare system and found that 1) it had a surgical complication rated of 5.3 percent and 2) the hospital system made $39,017 more per patient when there was a complication than when there was not.
Punchline from the article: “Effective methods for reducing surgical complications have been identified. However, hospitals have been slow to adopt them.”
Not trying to be cynical, but if you made $39,017 every time you had a bad result, you might be less likely to reduce bad results, too.
Dr. Atul Gawande makes the following points in an article in The New Yorker.
- Just like auto mechanics can “upsell” things for your car that are not necessary, doctors—both consciously and subconsciously—over-test, over-prescribe and over-operate on patients.
- Employers like Walmart have put in “Centers of Excellence” programs for surgeries that are frequently unnecessary, like back surgery. Employees are referred to a handful of Centers of Excellence across the country for a second opinion for major orthopedic surgeries like back surgery and joint replacement.
The result: The Centers of Excellence often find that the surgery is not appropriate and more conservative treatment, such as a steroid injection, physical therapy and pain medication, are more effective. Unnecessary surgery avoided.
Here are Dr. Gawande’s solutions for improving healthcare quality and lowering cost:
- Regulate prices that doctors and hospitals charge
- Break up big hospitals
- Encourage hospitals to become insurers… like the Kaiser Permanente system
- Expand Medicare to where everyone has Medicare and there is a single payer in America
I will conclude this blog with words from Dr. Atul Gawande:
“But, whichever way we go (and this being America, we’ll no doubt try to do some hodgepodge of it all), we cannot let the complexities blind us to the core concern. The one thing the medical profession is not rewarded for is providing better, higher-value care. We are financially rewarded either for doing more stuff or for securing monopoly power. In a fee-for-service payment system—a system of paying doctors and hospitals by pill and procedure—we are actually penalized for making the effort to organize and deliver care with the best service, quality, and efficiency we can. That’s why both public and private insurers are rolling out reforms like “bundled payments” (paying a package price for certain conditions) and “accountable care” (sharing savings doctors and hospitals produce from more efficient care)—they want to replace our system of paying for stuff with one that pays for outcomes.”
Want to know Dr. Gawande’s plans for the Amazon.com, Berkshire Hathaway, JP Morgan Case healthcare company? The answer is in that paragraph.
At Compass, we agree this is the right approach.
To learn more about how Compass healthcare navigation solutions help lower healthcare costs and improve care, please visit WhyHealthcareNavigation.com