Home > Employee Benefits > Healthcare reform should reward quality of care, not quantity

Healthcare reform should reward quality of care, not quantity

FierceHealthcare reported that “a new study by Merritt Hawkins reveals that physicians are compensated for patient volume and not quality, a trend that has some dismayed at current recruitment and compensation approaches.”  While the article was geared towards compensation practices for attraction and retention of hospital-employed physicians, it also reflects how an enormous driver of U.S. healthcare costs is going unaddressed.

Over the past two years, much debate and litigation has been directed towards the Patient Protection and Affordable Care Act (PPACA). In short, PPACA is a healthcare financing mechanism which provides for universal healthcare in America based on the mandatory purchase of coverage through health insurance exchanges. The act also provides patients with additional rights, especially with regard to pre-existing conditions and appeal of denied claims. While well-intentioned, the PPACA is essentially a financing mechanism that fails to address the root cause of rising healthcare costs, which is how American healthcare is delivered. Our healthcare system incentivizes quantity of care provided, not the quality or ultimate patient outcome.

I am a staunch supporter of prostate cancer awareness and research, but a stunning example of “quantity care” come to mind which is robot-assisted radical prostatectomy (prostate removal). Each surgical robot costs $1.5 million dollars, but a Journal of the American Medical Association (JAMA) study found that robot-assisted prostatectomy outcomes were no better than traditional open surgery and robotic prostatectomy now accounts for 60% of all prostate surgeries. Further, the JAMA study found that a surgeon needs to perform 150 robotic procedures before they are proficient in the use of the machine. I would not want to be part of that learning curve.

This is but one example of how American healthcare delivery is geared towards quantity of care, not quality. We could go on and on with other examples, but unless and until we address the root cause of rising healthcare costs, it does not matter which financing mechanism is deployed. In this era of weak economic growth and staggering budget deficits, we simply can not afford our current delivery model.

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William Gallagher Associates is a leading provider of insurance brokerage, risk management and employee benefits services to firms with complex risks and dynamic needs, within industries that include technology, life sciences, financial risks, health care, renewable energy & clean technology, and environmental services. WGA has offices in Boston, MA; New York, NY; Hartford, CT; Princeton, NJ; Columbia, MD; and Atlanta, GA.

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