Why do we need a value-based Healthcare System?

Covid-19 has caught us by surprise on many fronts, and one of them is the healthcare system. Recently I read an interview of Christian Fletcher, CEO of Atlanta based LifeBrite labs. Here he talked about the reasons the U.S. healthcare is in disarray. He ended it by quoting, “I believe healthcare can benefit from healthy competition and alignment on one simple mission – doing what is best for the patient.” Having worked in the U.S. healthcare industry for over a decade, I couldn’t agree with him more. 

Back to the pandemic, it is shocking to see the staggering number of deaths in the U.S. compared to the overall casualties across the world. The U.S. stands at almost one-third of the total fatalities of COVID-19.

This also speaks volumes about the overall state of the healthcare system, which is widely considered to be the most advanced worldwide. Sadly, the system failed many when it mattered most. There may be many reasons, such as the wrong approach to disaster management, failure of top leadership to foresee the loopholes in the system, and the overall seriousness of the disease.

The threat was understated many times as leaders quoted, “we don’t need to worry about the virus; everything is okay”. One cannot deny the healthcare system needs an overhaul considering it’s not achieving what it should.

What is wrong with the current healthcare System?

Let us discuss the challenges faced by the current system and how it impacts the key stakeholders in this industry. Many factors need improvement, such as the lack of oversight of commercial insurance payers, which causes independent providers to not get a level playing field and ever-increasing medical school costs, which results in students choosing other professions as they consider the financial burden, which eventually affects the optimal provider pool.

However, the most important aspect is the conflict of interest between the providers and payers. The provider’s focus is on getting maximum patient visits while the payer thinks the less the encounters the better chances of profit for them. The result is patients being deprived of the best possible health coverage.

With the payers solely focused on generating as much of a profit as possible, slowly and gradually, the overall purpose of healthcare has been defeated. The aim and mission of the healthcare industry should be the patient’s wellbeing. Until we fix the apparent conflicts and challenges in the current system, the situation will remain untenable.  

How will a value-based healthcare system help?

A disruptive change in an industry as massive as the U.S. healthcare industry can only happen if leaders in the federal government and business world come together and address the existing issues. It can’t happen overnight. However, one quick change that can happen is to move to value-based care.

This will encourage providers by giving them an incentive to provide better care to patients, and to make them healthy quicker instead of thinking about the financial impact of such. It isn’t difficult to conclude that this will ensure an overall positive impact for all parties involved; providers, payers and patients. Imagine providers giving their best quality of service and taking care of patients without worrying about any negative business impact.

Patients will recover quickly, move out of hospital facilities in a shorter period, and, last but not the least, payers will also not need to process as many transactions while making enough money to keep their business in good shape. Christian Fletcher mentioned that this has already begun at LifeBrite. It is a silver lining amid the chaos. I sincerely hope other industry insiders and business leaders take a recommendation from him and try to address this critical area of needed change.

Conclusion

The worst thing is not to understand the pain areas and problems because then you can’t fix anything. In the case of the U.S. healthcare system, it is a relief that we know exactly what the issues are and what course of action needs to be taken to make it better.

While governments and business leaders like Christian Fletcher work on refining the existing system, the onus also lies with citizens to reduce the burden on the system by taking responsibility for their wellbeing. This can be achieved by improving eating habits, regularly exercising, focusing on an active lifestyle, taking a break from technology, and moving closer to nature. We all know these are basics that can be achieved with a bit more self-awareness. 

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