I met with the advisor to a local University's Health Administration Program yesterday to explore Grad School options. One thing from the conversation stood out in particular.
During the initial phase of the discussion, I gave him a brief summary of my background in the healthcare industry and my career goals. I have one main goal for my career: Figuring out how to get rid of some of the waste in our country's healthcare "system". There are two main paths through which I can see myself accomplishing that.
- Lean Sigma or other process improvement methodologies. One of the biggest problems in heatlhcare is the inefficiency in care delivery. Changing nothing else to the system but more efficient process would have a huge impact on our healthcare costs. I've blogged about this previously, citing Virginia Mason in Seattle, Washington.
- Changes to reimbursement methodology that reward value-added services and eliminate incentives for non-value-added services. The Medicare Payment Advisory Council is currently the most powerful organization in the country at dealing with this aspect of improving efficiency in our healthcare "system".
When I mentioned this to the man I was meeting with he said "We already know the most efficient reimbursement methodologies. We already know what works and what doesn't, it's a political problem at this point." In other words, you can come up with the most brilliant research in the world that says "this is how we pay for this, this is how we pay for that" and it can be the most elegant solution that eliminates waste left and right, but if nobody can sell it to the American people or break through the hold powerful entrenched players have on the political system, it's not going to matter.
He's probably right. Or more accurately, he's right. But does that mean that everything's already been figured out? Maybe MedPac doesn't really know everything yet and the research is just as big a part of the equation as the political side. Because once the political side does win out, the methodology for reimbursement better be damn good or the political battle will be that much harder the next time around.
Luckily, the discussion put me on a path towards a degree that purports to address both tracks 1 and 2 towards healthcare reform. So... I'm going back to school!