These posts are written to summarize what I learned participating in Medecision’s annual meeting of the company’s partners, held March 27-29, 2018 at the Ritz-Carlton in Dallas, TX. – Jane
Part 3: From the fog of war to re-imagining American healthcare
By Jane Sarasohn-Kahn
Tan Le, whom I introduced in the conclusion of the second part in this blog series, said at Liberation 2018,
“The tempo of the dance will increase.
We will move away from the static certainties of the past.”
Uncertainty is a fact in U.S. healthcare as we move from the “static certainty” of fee-for-service reimbursement to value-based payment.
Governor Mike Leavitt’s metaphor for this shifting paradigm and how we’re feeling as we travel through it was, “the fog of war.”
“Uncertainty freezes us,” Gov. Leavitt observed, citing the experience of General Carl von Clausewitz. In his book, On War, Von Clausewitz wrote:
“War is the realm of uncertainty; three-quarters of the factors on which action in war is based are wrapped in a fog of greater or lesser uncertainty. A sensitive and discriminating judgment is called for; a skilled intelligence to scent out the truth.”
Thus emerged the concept of the fog of war, and the uncertainty that arises in that haze. What an apt context for where we are in U.S. healthcare at this moment.
How to deal? Gov. Leavitt noted that Von Clausewitz said, “go high,” gaining strategic perspective over a war-torn field by moving higher and higher to survey the situation.
Going high in healthcare means gaining perspective – putting ourselves in patients’ and providers’ shoes by meeting people where they are. As I discussed in the second post of this three-part series, the importance of user-centered design cannot be underestimated. Adopting UX, UI, CX, and service design principles must become part of healthcare providers and payers natural workflow and investment allocations.
This is so important because of the move to value. The United States has an unsustainable economic model for healthcare, and value is the economic imperative, Gov. Leavitt implored us.
“We have the opportunity to create a uniquely American healthcare system,” Gov. Leavitt optimistically informed.
I would argue that “we” in the creation of that reinvented U.S. health system, includes patients – consumers, caregivers, all.
For those detractors of the concept that consumers should co-create health with providers – that patients aren’t up to the challenge – I turn to Tom Cruise and Jack Nicholson in the iconic scene from A Few Good Men and rephrase the climactic moment by asserting,
“Patients can handle the truth…and the responsibility.”
Gov. Leavitt noted that the 2003 Medicare Modernization Act, which featured Medicare Advantage and Part D for prescription drugs, drove consumerization. “We learned that consumers could learn, select,” among health insurance plans and prescription drug programs.
In my own work during that implementation phase, I observed seniors learning how to go online with grandchildren or librarians to sign up for drug benefits. I also collaborated with California HealthCare Foundation on a 2010 study which surveyed health plan enrollees’ use of personal health records via portals at Kaiser-Permanente, Group Health Cooperative, and in the VA, finding that once a patient learned how to access a portal and go online they were actually inspired to ask more question and engage more deeply in their health are with providers and plans.
We know Millennials are demanding digital health tools and mobile access from providers and plans. But it will also be true that Boomers, who have transformed many institutions and organizations, will not go so gently into the unhelpful healthcare environment as they age into retirement and Medicare.
Consumers are ready to co-create health and partner with those providers who meet them where they want to meet up.
Deb Gage, Medecision CEO, adopted the mantra, “I persevere.”
Tan Le’s word was, “persistence.”
Can we join these inspiring, strong women in the goal of co-creating that uniquely American health system?
I say, “yes.” Let’s make it happen, together.
About the author
Jane Sarasohn-Kahn is a health economist, advisor and trend-weaver to organizations focused at the intersection of health, technology and people – especially consumers, patients and caregivers. She is the founder of THINK-Health and the Health Populi blog, and serves on the advisory boards of CanSurround, CAQH’s U.S. Health Efficiency Index, the Center for Health Policy and Media Engagement at George Washington University, healthBank, Stupid Cancer, WEGO Health, and Women of Color in Pharma. In her community of Phoenixville, PA, Jane sits on the Board of The Clinic, a free clinic for residents. Jane is a frequent speaker, listed with AHA’s Speakers Express and Executive Speakers Bureau, as well as a contributor to the Huffington Post. Jane holds an MA (Economics) and MHSA (Health Policy) from University of Michigan.