Three Reasons Delivery System Transformation Is Here to Stay

By Carol Backstrom
Principal and Director, Delivery System Transformation

Much has been said (and speculated) about the future of the Affordable Care Act, Medicaid expansion, and insurance exchanges. While policy makers and pundits in Washington agree that change is afoot, one thing seems clear: health care delivery system transformation is here to stay.

In 2008, Institute for Healthcare Improvement researchers created a way of defining delivery system transformation via the Triple Aim: improving the health of the population, enhancing the experience and outcomes of the patient, and reducing per capita cost of care. This meant changing the way health care was delivered – which felt lofty and perhaps even unattainable. Now it’s very much embedded in our everyday vernacular. Delivery system reform is here to stay. Why? Three reasons:

  1. Aiming for higher quality and better outcomes is fiscally smart. If there’s one thing Democrats and Republicans can agree on, it’s that waste and duplication costs money. And while reforming our health care system requires investment up front (things like heath information exchange, personnel changes, and care coordination), the long-term benefits include reduced hospitalizations, more efficient care, and improved quality, all of which reduce costs. Just look at the work that the New York hospitals have taken on by creating Performing Provider Systems.

  1. The evidence is getting stronger every day. Ten years ago, medical homes and accountable care seemed like foreign concepts. While transformation to value-based care has been anything but linear (or easy), hospitals, health plans, state Medicaid programs, and Medicare have joined together to become laboratories of change. Research shows that improvements in quality and cost, while incremental, are making a difference in the way we deliver care.

  1. Patient-centeredness is the right thing to do. At the heart of patient-centered care is the realization that social determinants can have more impact on health outcomes than the quality of the care itself. For example, if primary care is located across town from social workers and psychologists, patients can be forced to choose which service they need more, which can lead to poor health comes and high emergency room use. We’ve learned that co-location of services and access to social supports keeps people out of the emergency room. Not only does that improve health outcomes, but it really defines person-centered care. A great example of this work is underway in California via the new Whole Person Care Pilots.

Regardless of what happens in the halls of the Capitol, the momentum behind delivery system reform is not going to wane. And that’s something we can all get behind.