An agenda for mutual responsibility for the 21st century
For some time now, IBM has been calling for a "smart" healthcare system that would help healthcare research become more informed and intelligent, and providers to deliver safer, more efficient and individualized care.
In recognition of our company's leadership in healthcare reform, the U.S. House of Representatives Committee on Ways and Means (link resides outside of ibm.com) invited IBM Senior Vice President of Human Resources Randy MacDonald to participate in a panel discussion of healthcare reform on April 29, 2009. MacDonald also serves as chairman of the HR Policy Association (link resides outside of ibm.com), a group of chief human resource officers from more than 260 U.S. corporations.
IBM believes a "smart" healthcare system will vastly improve healthcare decisions and deliver greater efficiency by eliminating waste and needless administrative cost. MacDonald told the committee that IBM supports healthcare reform that focuses on mutual responsibility—among patients, providers, insurers, governments and employers.
IBM recommends a national healthcare agenda that meets seven key objectives:
- Strengthens our voluntary employer-based system with reforms that contain skyrocketing costs and improve health outcomes and accountability.
- Adopts a comprehensive national reform agenda avoiding a potential patchwork of state-by-state solutions that would prove unwieldy for national employers.
- Improves wellness, prevention and primary care, incenting providers to not simply treat the sick but to keep patients healthy.
- Creates a competitive and accountable marketplace by providing improved consumer information and meaningful choice.
- Controls costs and reduces cost-shifting restructuring public programs away from traditional "fee-for-service" reimbursements.
- Ensures all Americans have health insurance using solutions that account for the different circumstances within that population.
- Promotes adoption of health information technology. Broader adoptions will result in safer and more convenient care for patients, at lower administrative costs.
The company also supports an initiative known as the "Patient-Centered Medical Home" (PCMH), a model based on the concept of "comprehensive primary care," which focuses on strengthening the primary care/physician relationship to enhance communication and improve care across the healthcare delivery system. Giving patients a "medical home" is meant to fix some of the principal shortcomings of how healthcare is delivered and paid for in the U.S. Insurers now typically reimburse doctors based on how many tests or procedures they perform, instead of how effective their care is.
Point of View
"Currently, very few practices in the U.S. have a forum for quality improvement to ensure employees and insurance companies are getting their money's worth. From my own experiences, the 'medical home' model goes a long way toward creating a system that gives every patient access to quality primary care. It has already saved North Carolina $150 million a year in healthcare costs.
But medical home requires doctors who are committed to providing comprehensive, high-quality primary care, and the pipeline for primary care physicians is drying up. Medical students are simply not choosing family medicine and general internal medicine, and the distribution of pediatricians leaves many rural and inner city populations without access to optimal child health services.
If the industry—and major employers—feel strongly enough about the primary care option and changing the healthcare system in this country, they may need to get involved in transforming our medical education system."
David T. Tayloe, Jr., MD, FAAP, 2008-2009 President, American Academy of Pediatrics
Point of View
"Recently we formed a Patient-Centered Primary Care Collaborative, joining with major employers, consumers, health plans and other key stakeholders to promote the patient-centered 'medical home' model nationwide. This model, which focuses on wellness and prevention as well as chronic and acute care, is based on the principle that patient care is better when individuals have a sustained and localized relationship with their healthcare providers.
ACP and the members of the Collaborative believe that the 'medical home' concept holds great promise as a way to transform the U.S. healthcare system. Health information technology can play a major role in making the system more efficient—providing access to expert knowledge at the point of care so providers get the right information, at the right place, and at the right time. Technology also enables 'interoperability'—the exchange of patient care information between care providers and hospitals in different states—so there is no lapse in delivering proper care."
Dr. John Tooker, Executive Vice President and Chief Executive Officer, American College of Physicians (ACP)
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