Focus on reducing cost by helping providers provide higher value care
Where the ACA was focused initially on improving access, just as important is the need to reduce cost. And the best way to reduce cost is to reduce the high amount of inappropriate/unnecessary care, low quality care and high total cost care occurring in the system by providers. Put more succinctly, we have a lot of providers delivering very poor care, very low value care – and they often don’t know it or recognize it. I believe the incoming administration needs to invest in a system/approach, using the robust data we have access to, coupled with deep analytics and clear insights, that enables providers to better understand how they are practicing, what “good” looks like and how they compare to that standard. And then we need to hold those providers accountable to improving how they practice relative to that “good” standard, including being prepared, in some cases, to tell them that they shouldn’t be allowed to practice if they don’t improve. Based on work I’ve been involved with, the potential savings from this effort is certainly in the $100’s of billions, if not more.