Harvard Business Review | Michael Porter & Thomas H. Lee
In health care, the days of business as usual are over. Around the world,
every health care system is struggling with rising costs and uneven quality
despite the hard work of well-intentioned, well-trained clinicians. Health care
leaders and policy makers have tried countless incremental fixes—attacking
fraud, reducing errors, enforcing practice guidelines, making patients better
“consumers,” implementing electronic medical records—but none have had much
impact.
It’s time
for a fundamentally new strategy
At its core is maximizing value for patients: that is, achieving the best
outcomes at the lowest cost. We must move away from a supply-driven health care
system organized around what physicians do and toward a patient-centered system
organized around what patients need. We must shift the focus from the volume
and profitability of services provided—physician visits, hospitalizations,
procedures, and tests—to the patient outcomes achieved. And we must replace
today’s fragmented system, in which every local provider offers a full range of
services, with a system in which services for particular medical conditions are
concentrated in health-delivery organizations and in the right locations to
deliver high-value care.
Making this transformation is not a single step but an overarching
strategy. We call it the “value agenda.” It will require restructuring how
health care delivery is organized, measured, and reimbursed. In 2006, Michael
Porter and Elizabeth Teisberg introduced the value agenda in their book Redefining Health Care. Since then, through our research and the work of thousands of health care
leaders and academic researchers around the world, the tools to implement the
agenda have been developed, and their deployment by providers and other
organizations is rapidly spreading.
The transformation to value-based health care is well under way. Some
organizations are still at the stage of pilots and initiatives in individual
practice areas. Other organizations, such as the Cleveland Clinic and Germany’s
Schön Klinik, have undertaken large-scale changes involving multiple components
of the value agenda. The result has been striking improvements in outcomes and
efficiency, and growth in market share.
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There is no longer any doubt about how to increase the value of care. The question is, which organizations will lead the way and how quickly can others follow? The challenge of becoming a value-based organization should not be underestimated, given the entrenched interests and practices of many decades. This transformation must come from within. Only physicians and provider organizations can put in place the set of interdependent steps needed to improve value, because ultimately value is determined by how medicine is practiced. Yet every other stakeholder in the health care system has a role to play. Patients, health plans, employers, and suppliers can hasten the transformation—and all will benefit greatly from doing so.
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συνέχεια… https://hbr.org/2013/10/the-strategy-that-will-fix-health-care