Patients are confused on how to access healthcare, and there is a specific reason why, according to one health executive.
“I think the challenge we have is the U.S. healthcare system is not really a system,” said Andrea Walsh, president and CEO of HealthPartners, an integrated healthcare provider and insurance company. “We’re a collection of solutions that are in the moment and we leave consumers to figure out what they need when they need it. So there’s no true navigation.”
Walsh made these comments Wednesday at the HIMSS 2023 conference in Chicago, and added that the industry needs to change to make it easier for patients to navigate care.
“I think part of the quest and part of this conversation around disruptive innovation is, how do we break apart the current system and put it back together in a way that assures that as healthcare consumers look to stay healthy, or take care of themselves when they’re sick, they know what the front door looks like and how to access the front door,” she said.
Tim Barry, co-founder and CEO of VillageMD, was also a panelist and agreed with Walsh’s comments about the system being broken. However, he said that in this fragmented system, there is one thing that works: seeing patients as much as possible.
“Basic blocking and tackling is what works,” Barry said. “When patients are discharged from a hospital in this country, 6-7% of them get seen by their [primary care physician] within 48 hours. That’s a failure. That’s an F for the U.S. healthcare system. How many studies do we already know that getting a patient post-discharge to see their [primary care physician] in a timely manner is going to prevent readmissions? What can we do? We can freaking focus on it.”
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
He added that patients want this high-level support and communication from their physicians.
“One of our biggest challenges of rolling out models and programs to take care of patients who have chronic disease is that we have doctors saying, ‘Well, I don’t really need to see that patient every 30 days.’ Well guess what? They want to see you. Stop devaluing yourself. They want your hands on their back, they want to know that you care,” Barry stated. “So let’s create more touches.”
Barry said that moving away from the fee-for-service model and towards a risk-based and value-based care model could help improve the fragmented system.
“People are trying to optimize their silo, which is every single reimbursement and fee-for-service,” he said. “Within the silo, there’s thousands or millions of other little silos. What we’re saying is, forget it. What matters is, are we taking care of the patient? Is the patient getting a great experience? Are we spending time with the patient?”
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