MedicalResearch.com Interview with:
Barbara L. McAneny MD, CEO
New Mexico Oncology Hematology Consultants, Ltd.
Albuquerque, NM 87109
MedicalResearch.com: What is the meant by value-based care?
Response: There are a lot of people using this term to mean a variety of things, confusion is not surprising. Generally it means a move to pay more for better patient outcomes and less for worse patient outcomes. Currently in our Fee for Service system, there are a lot of services for which there are no fees. That deficiency keeps physicians from looking at non face-to-face delivery methods or the use of other health professionals to augment the care they give, because we can’t afford to give services that we aren’t paid to give.
MedicalResearch.com: How does value-based care work to improve clinical outcomes, conserve financial resources and at the same time limit medical liability and improve patient satisfaction?
Response: In my view, value based care involves more education of patients by physicians about the therapeutic options available and determining—with the patient— reasonable goals. If we can link the therapy to the patient’s goals, then in their eyes the care will be better, and that is what matters, even if it is difficult to measure. I have found that when patients understand the limitations of what we can provide, understand the risks and benefits, they are less likely to assume that a bad outcome is anyone’s fault. That lessens liability. In addition we feel that value based care involves getting the patients what they need, when they need it, and early enough to prevent complications requiring hospitalization. Patients understandable love that—they much prefer feeling better at home than feeling worse in a hospital.
MedicalResearch.com: What do you see as the biggest challenges facing US health care today? What are one or two of your suggestions for overcoming these obstacles?
Response: The biggest challenge is the high cost of the care we give. Part of that high cost can be addressed by streamlining the processes attached to health care. Why should it cost up to 14% of the bill just to get the bill paid? Why are we paying people to prior-authorize treatment that is the standard of care? Why do we not have the ability to let patients and doctors know the cost of what we order, and where those tests or medicines can be obtained for less money.
The second issue will be the physician workforce. We have a shortage looming, and we are driving physicians out of clinical practice by forcing them to be data entry clerks. We need to allow physicians to spend their time with patients if we are going to keep them in the workforce.
MedicalResearch.com: Is there anything else you would like to add?
Response: If we are to truly move to value based care, and provide care to everyone who needs it at a lower cost, it is a mathematical certainty that some entities will find their revenue streams diminished. We need to take a hard look, as a nation, at what parts add value and what parts just funnel profits. For the essential pieces, we must conserve a sustainable margin. For example, if we value having emergency services available, why do we make hospitals fund them by cost shifting from more lucrative services like imaging. We should directly fund emergency services and let imaging services reflect their true price.
If we want healthier people why are we not investing in more primary care, and outpatient specialty care instead of building more hospital beds.
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Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.