A 1990s employer coalition in Rochester NY, led by Kodak, created the best healthcare value (health/dollar) in the US by purchasing value, not just volume. Kodak's decline destroyed the magic, but many here remember how well it worked. A small committed Rochester group plans to spawn another coalition to drive a local data-driven health utility. It will incorporate our Regional Health Information Organization, a sophisticated survivor of our high value days. The key element: value measurement based on each provider's healthcare outcomes; quality defined only by process measures misses too much of the opportunity. This outcomes analysis must be risk-adjusted with a sophistication that will create enough trust within the physician community to accept value-based reimbursement.
Our healthcare system will reform itself around these new economics, which will pay appropriately for prevention (an expensive disease that did not occur) and better disease treatment value (e.g. back pain treated mostly without surgery and narcotics). Modern health information systems coupled to our region-wide "clean" database promise much better results than our qualitative efforts of the 1990s. Additionally, robust funding of each physician's good value decisions is expected to cause much local innovation and value creation.
Rochester is an ideal community for this experiment in regional reform of the healthcare system. Our success can be spread quickly. Regional healthcare reforms make much sense because the social determinants of health are so different in each region. We are incorporating these data in our RHIO database to create additional tools for healthcare providers and patients to create health at a low cost.
We are reaching out to the PIN community seeking advice, and expertise in healthcare outcomes measurement, risk adjustment methodology, and dashboard presentation of each patient's high-value opportunities to physicians and patients.
About the Author
George Anstadt, MD, FACPM, FACOEM is the former Director of Health Plans for Eastman Kodak, AMA Section Council on Preventive Medicine Past Chair, Professor of Preventive Medicine and Entrepreneurship at the University of Rochester, and helped build the Kodak EMR. Dr. Anstadt has also worked with start-ups in health informatics and wellness.