OVERALL USHEALTHCARE INDUSTRY STRUCTURE Presented by Philip Corsano CEO Gnostam Consulting
How to drive costs down? Collect data, is there an “exchange” where the data for price and service delivery lives? Understand what part of the “value chain” you occupy; Build an economic model; Optimize strategic choice by running scenarios’s; Quality improvements; Process improvements;
The Problem Overuse, inappropriate use of care, fee for service; Payment incentivizes delivery of more service; Old oligopolistic market structure, favors big pharma, big insurers, and suppliers who restrict efficient price discovery; Barriers to access in primary, preventive care, leads to over use of Hospital admissions, ER and complications of chronic acute disease.
Health Care Costs Concentrated in Sick Few—Sickest 10 Percent Account for 64 Percent of Expenses 1% 5% $36,280 24% 49% $12,046 50% $715 Distribution of health expenditures for the U.S. population, by magnitude of expenditure, 2003
The Model First acquire the procedure data, best if payment for services with an outcome: Is there an obvious process for price discovery? Is the data in a form that allows for like with like comparisons? Is there a model against which to benchmark? Is there a process improvement component? Is there a quality control, reliability component?
Tools for Improving How We Do Our Work: Improving the Process Process flowchart Cause and effect Category Frequency A lll Data Collection B llll ll C llll Data Analysis
Tools for improving what we do: Content Benchmarking best practice Field force analysis Driving Restraining Evidence based practice, run scenario’s
Leverage performance improvements How we think Appreciating a Systems Perspective What we do Addressing Underlying Assumptions: •Goals •Purpose •Measurement •Traction •Implementation •Teams How we do it •Improving Content •Improving Content •Improving Process •Improving Process •Improving ProcessLow leverage High Leverage
Thank youfor your attention Philip Corsano Gnostam Consulting LLC 5731 Kirkwood Place N Seattle, WA 98103E-mail: email@example.com or firstname.lastname@example.org Tel 206 384 0069 www.gnostamconsulting.com
One idea for the New System, Medicare for all. REJECTED