I wrote my honors thesis on the interdependence of patients, payors, providers, and the folks that pay for innovation to happen. At the time I was focusing on the role venture capitalists played in the world of medical devices, but looking back, it may as well have been the role of pharmaceutical companies in developing new molecules or the NIH in studying epidemiology. The point of my thesis did not depend on who the actual financial player was, but the fact that the rate and direction of innovation were invariably tied to their existence. While many organizations claim to focus on specific ailments for the greater good, the truth is that the dollar amount tied to reaching each target justifies the strategy. The patient, payor, and provider were merely metrics in the calculation.
However, the point of this post though is not to argue about the business end of research. We all know about the disparity that goes on in the pharma world – the fact that some illnesses get more favorable grants, or that media and celebrity enable certain issues to get more attention than others (think the attention Michael J Fox has put on Parkinson’s), while other illnesses that affect a smaller, less well known population are left behind. The point of this post is to shine light on how today’s reimbursement model, left unchanged, sets us up to fail.
Today’s reimbursement model sets us up to fail. That’s a loft statement, I know. Let me be more specific. Innovation is the drivetrain that will enable us to actualize full coverage. Skype appointments, SMS-based scripts, email diagnosis, and smartphone-enabled annual physicals will mitigate physician shortages, but more importantly, will allow us to cut costs and deliver healthcare to many that are currently underserved. These examples are just the beginning of how technology can be employed to deliver more efficient, more affordable healthcare, but they may not go very far. Why? Today’s physician is not set up to be reimbursed for services rendered outside of the traditional model. I’ll follow up further on this topic, because I think it’s an important one, but for now, I’ll just leave at this: innovation can not be constrained to a single sector of healthcare – in order for the healthcare delivery model to change, innovation must be be born from a collaboration between payor, provider, (pharma), and technology to be successful.
I <3 Healthcare 