The U.S. healthcare system is not merely ripe for disruption, it is practically begging for it, according to former National Coordinator for Health IT David Blumenthal, MD.
In a Harvard Business Review Article published Thursday, Blumenthal poses the question: “Are old-guard institutions, like hospitals and nursing homes, on the verge of extinction?”
Take CVS’s planned $69 billion acquisition of Aetna and UnitedHealth’s $4.9 billion deal to buy DaVita Medical Group, as two prominent examples.
[Also: CVS-Aetna merger will make an even bigger giant out of Epic]
“The big question is whether these bold new combinations of insurer and provider can generate promising partnerships similar to a Kaiser or an Intermountain, or find some other equally powerful formula for disruption.”
The reason this matters right now: Care is fragmented, inconvenient, hard to access, Blumenthal added, and that holds true most of all for the sickest people.
[Also: Optum Ventures is looking for startups that will make fundamental changes to healthcare system]
But if executed properly, the joint provider-payer organizations take on financial risk and responsibility for patients and the care clinicians deliver which, in turn, effectively forces everyone to focus on value.
Not that success is a foregone conclusion that will come easily. Blumenthal also pointed out the future is uncertain and challenges remain, notably scaling UnitedHealth into a national enterprise and in both cases coordinating with healthcare systems and providers outside their own organizations.
“It should come as no surprise, then, that when titans of our private, for-profit healthcare sector — like Aetna, CVS, UnitedHealth Group (UHG), and DaVita — strike out in new directions, stakeholders react with fascination and excitement,” Blumenthal wrote. “Could this be it? Is free-market magic finally bringing Amazon-style convenience, quality, and efficiency to healthcare?”
Twitter: @Bernie_HITN
Email the writer: bernie.monegain@himssmedia.com
