On the road to Accountable Care

WP_000396I spent the end of this week on the road in the Boston area. On Thursday morning, I delivered a keynote for a meeting organized by the Massachusetts Hospital Association at the Waltham Woods Conference Center in Waltham, Mass. The theme for the meeting was “Opportunities and New Frameworks for Hospital/Physician Alignment in an Era of ACOs and Changing Payment Systems”. If that sounds dull, surprisingly it wasn’t. Besides my opening keynote on how software and the “consumerization” of IT are transforming health and healthcare delivery, the program featured Cliff Bleustein, MD, Health Industry Advisory Practice, PricewaterhouseCoopers. Dr. Bleustein elaborated on the latest trends in hospital acquisitions of physician practices and provided guidance for hospital executives on how to successfully work with clinicians toward mutually beneficial goals under the constraints of new payment systems and health reform.

Massachusetts is often cited as the birthplace of modern health insurance reform and is held up as a national model for the kinds of changes that are on the horizon across America. Therefore, you might assume that hospitals and clinics in the state have ACOs and new payment models all figured out. It’s pretty clear to me that they are struggling with the concepts as much as organizations elsewhere. Since large health systems in Boston are famous for a “not invented here” attitude, I found it refreshing that they were willing to bring in experts from across the country to get fresh perspectives on national, and in my case, global trends. It was a genuine honor to speak at the MHA event.

Thursday afternoon I headed down to Boston to be a little closer to Logan Airport and my flight back to Seattle on Friday morning. On the advice of some airline friends, I booked a room at the Seaport Hotel on the waterfront near the Boston World Trade Center. When I arrived, I realized that I had stayed just a block away on a previous visit to Boston. None-the-less, the view from my room was exactly what I needed after a long day of meetings in Waltham.

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I’m sometimes amazed how airports, cities, hotels and locations all become a blur when you travel the world as much as I do. Have you ever booked a room at a hotel thinking you’ve never been there before only to realize when you step into the lobby that this is not your first visit? Such is the life of road warriors. In any event, I would highly recommend the Seaport. It is reasonably priced and the location is great if you enjoy a waterfront venue with a wide variety of trendy restaurants, bars and quaint little shops. And, it’s only 15 minutes by cab back to Logan Airport.

imageI’ll close out this post with some recommended weekend reading courtesy of my colleague Will Falk, Executive Fellow at the Mowat Centre and Adjunct Professor for the Rotman SoM at the University of Toronto. You see, it’s not only America that is struggling with spiraling healthcare costs and concerns about aging populations and the increasing incidence of chronic disease. Developed nations around the world are confronting the consequences of this amidst a climate of economic slowdown and budget constraints. The National Health Service in the UK is going through a dramatic decentralization. In Canada, healthcare costs are projected to gobble up as much as half of the entire budgets of provinces like Ontario. While some experts are calling for salvation through privatization of public health systems like that in Canada, a new whitepaper by Mr. Falk and his colleagues takes a much different stance. It strongly recommends maintenance of the public system while embracing four tenants. They are:

  1. Use disruptive innovation as a framework to understand changes in technology and service delivery.
  2. Recognize that Moore’s Law, which suggests declining costs over time, applies to healthcare and recover productivity gains as they emerge for the public purse.
  3. Focus on improving quality and access as costs decline.
  4. Treat healthcare as a high tech industry.

There is much to be said for the kind of transformation being suggested here without dismantling the promise of affordable, fair and equitable healthcare for all citizens. Like I said, this one is definitely worth a read even if you’re not Canadian. You can download a copy of “Fiscal Sustainability and the Transformation of Canada's Healthcare System: A Shifting Gears Report” by following this link.

My next visit to Boston will be in early February. I have been invited to provide the closing keynote for this year’s Harvard Business School, Annual Conference on Health on Saturday, February 4th, 2012. Perhaps I’ll see you there.

So, from 35,000 feet high above somewhere in mid-America on Alaska Airlines flight 25 from Boston to Seattle, I wish you a very restful weekend.

Bill Crounse, MD Senior Director, Worldwide Health Microsoft

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