for DR.SAMUELSON ONLY!!!!
frguerradi
week7-pp-hpa.pptxMCHM 6301: Health Care Policy Analysis
WEEK7:The Role of health care professionals, and the force needed to push the U.S. Healthcare system in the right direction.
Overview
What the health care professional means to the health policy analysis process.
The importance of physician participation.
Managing risks.
Leadership development.
Teamwork
How to move our health care system in the right direction.
Why Health Professionals Are Important to Health Policy Analysis
Bringing technical knowledge to the table
Bringing clinical experience to the table
Bringing commitment to the patient
Knowing role of both science and art and difference between the two.
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Why Clinicians Need to Participate in Health Policy Analysis
Continuing loss of influence otherwise, due to:
Loss of apparent disinterestedness
Disintermediation by other actors
Loss of control of information side of care
Government pressure to increase competition
Industrialization of care erects new barriers
New opportunities to orchestrate care in the decentralized system
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There are other risks to learn to manage
Not just financial and clinical operations
Underwriting
Marketing
Regulation
Negotiating, and
Integrative, for which HEALTH POLICY ANALYSIS is one schoolyard.
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What Are Leadership Processes I Could Participate In Now?
Institutional governance
Institutional planning
Professional governance
Professional policy analysis
Community planning processes
Advocacy group governance
YES, WE KNOW TIME IS AN ISSUE, but it won’t happen by itself.
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Teamwork
Hardly any other word is so badly handled in health care.
Many health providers make relatively poor team members.
Management training can either help with or exacerbate the process. Make sure you get sufficient feedback to know how your peers perceive your behaviors in teams.
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Where to Stand?
The lever system has three components:
Lever
Force
Fulcrum
We and others have presented many levers
There are many forces at work, but the benign ones seem to have no fulcrum of of which to work.
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Fulcrum Weakness
Market conditions
Consumer lacks technical info and background to interpret it
Consumer doesn’t always have sufficient acuity to use what he or she knows
Consumer lacks access to cost information
Consumer lacks access to quality information although that is improving
Public lacks confidence to act on its own knowledge and often a PCP as a guru
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Weakness of Free Market Approach
Low hanging fruit picked by increased copay and deductibles
Continue lack of price/quality transparency
Need for lay decision makers to
Be able to interpret technical information
Have mental acuity/consciousness to decide
Have full confidence in own judgment
Limite access to PCP for reality check
Physician’s Position Weakening
Information monopoly down
Procedure monopoly also affected
Participation in bundled pricing will weaken pricing power, witness academic practice
Increasingly constrained by payers and regulators
Some actions give freedom but reduce credibility, e.g., specialty hospitals
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ERISA Problem
States can only manage part of insurance market
However, that problem gets less and less as employers bow out
Could go the “uniform model codes” route to constrain remaining holdouts
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