I was fascinated last month when I ran across an article in The New York Times under the headline, “New York City Ties Doctors’ Income to Quality of Care.” The article, by Anemona Hartocollis, began thus: “In a bold experiment in performance pay, complaints from patients at New York City’s public hospitals and other measures of their care—like how long before they are discharged and how they fare afterward—will be reflected in doctors’ paychecks under a plan being negotiated by the physicians and their hospitals. The proposal,” Hartocollis wrote, “represents a broad national push away from the traditional model of rewarding doctors for the volume of services they order, a system that has been criticized for promoting unnecessary treatment.”
The Times article goes on to explain the core terms of the Affordable Care Act-mandated value-based program under Medicare, and to quote Alan Aviles, president of the New York City Health and Hospitals Corporation, which runs the city’s 11 public hospitals, as to why that organization is tying physician raises to their performance on value-based purchasing measures mandated by healthcare reform. And, as it usually does, the Times writer gives this story the thorough Times treatment.
I’ve written before about mainstream media coverage of healthcare; it is an area of particular interest for me as a journalist on the trade press side of the profession. I’ve often been frustrated by how superficial mainstream media coverage has been of federal healthcare reform specifically and of healthcare policy and industry topics more generally. But here’s the thing: as the ACA’s specific provisions begin to filter into the warp and woof of healthcare delivery and operations on a day-to-day level, more mainstream media coverage will be bringing “civilians” more insights into how healthcare really works. And that will be both an excellent thing, and possibly an increasingly uncomfortable thing, for healthcare professionals, including healthcare IT leaders.
In short, it will become less and less possible to hide behind the usual “I won’t bother to explain it because it’s just too complicated for you to understand anyway” bromides. And that means that fewer healthcare industry open “secrets” will remain “secret” much longer. Think of the hospital bill and its obfuscations, for example; or of the problems involved in hospital discharge planning.
And, as I’ve long predicted, consumers’ awareness of actual clinical outcomes ratings systems, federal, state, and private (such as via the numerous business purchaser coalitions), will become greater over time.
Already, hospitals and medical groups are promoting their EHR implementations on billboards and in local TV ads.
The world is changing, more rapidly than some in healthcare might realize. And guess what? The transparency we’ve all been talking about as a necessary component in the new healthcare is emerging now.