Direct Health Delivery, as its name suggests, advocates a more direct interaction between a patient and their physician. By lessening intervention, DHD alleviates the bottlenecks that undermine the patient physician relationship and inflates the price of care.
The prime vehicle of DHD is price transparency—an upfront disclosure of the predictable costs related to treatment and care. The intrinsic openness of transparency requires that treatment prices reflect the actual cost of providing treatment. It’s a market-based compliance, if you will, that automatically disallows the arbitrary setting of prices.
The Impact of DHD
The impact of DHD is threefold: 1) upholding the patient-physician relationship; 2) reducing unnecessary intervention; and 3) realigning pricing of care with the fundamental cost of providing care.
The latter tine of the threefold fork substantially reduces the cost incurred by payers through the intrinsic openness of transparency.
The DHD Business Solution
It is self-insured employers who assume health claim risks and shoulder much of the payment burden. The risks are getting higher and recently spilling into many other stakeholders’ business models. Patients are increasingly aware of the economic risks and are seeking transparent solutions. They are being asked to become consumers. Consumers can not wisely choose without transparency.
All the stakeholders stand to gain by tapping into the transparency model, and in turn they (all stakeholders) constitute the model’s primary market segment and audience.
There are currently 1,370 self-ensured companies based in California, covering many lives/members. Best estimates from national averages (60% of work force) and Bureau of Labor Statistics indicate no less than 10,000,000 people in Ca are covered under a self-funded benefit Health Plan.
As such, the DHD business solution involves forming a nationwide panel of providers who: 1) will care for the workforce of the self-insured, and 2) will do so transparently. DHD will marry this countywide provider panel to the country’s self-insured lives by packaging transparency into an out-of-the-box, easy-to-use product for employers and their staff.
This model will be the cornerstone of tangible healthcare reform and the future healthcare delivery in the US. It certainly is a commonsense alternative to the prevailing pattern of costly and unpredictable delivery systems.
No more Grand Canyons in healthcare
The massive separations between the important plateaus in Health Care delivery in the United States will be fading soon. In the movie Back To The Future, Marty Mcfly’s image on a polaroid picture is dramatically fading when the threat of his whole existence increases. If his parents don’t unite, back in high school, his existence flickers on the screen. Polaroid, incidentally, filed bankruptcy in 2001 after digital adoption, but I digress.
As the expansive canyons fade, the costs will be brought down by the empowered patient. The patient needs, information + newly engineered model + aligned incentives. That is all.
In healthcare, the constellation of many critically important stars have to orbit in a sustainable energy field. Trying to enumerate them would be a second digression. So I shall spare you this one. But it is important to emphasize that very charged personal, individual, financial, economic, political stargazing has been going on for the recent few years.
The faster the canyons disappear the sooner valuable resources will be spared the current inefficient model.
Forced evolvement and recent M&A’s are indicative of the unsustainable legacy model regardless of the good intentions. It is attempting to go against the constellation order and is not natural. Forced evolution is just as unsustainable no matter how well intended, well funded, backed by force, decree or finance. Billions have been exhausted in the last four years experimenting with models that delivered less than desired outcomes even after IPO’s.
Natural evolution in healthcare is empowered by two incomprehensibly powerful field forces: individual human as well as group and collective Health and Wealth.
Natural evolution is starting to take shape in many small, underfunded, not yet digitalized, disconnected and remotely distant parts of the same constellations. Part of the natural evolutionary process is the inherent attracting energy forces even when the parts being drawn closer are unaware of such gravitation.
In paraphrasing W.H. Auden: We would rather be ruined than changed. We all have defense mechanisms to ensure that the world stays the way we expect it to be. Folks, it is not folklore any more. Current neuroscience confirmed these facts. David Rock’s books, “Your Brain At Work” and “Quiet Leadership” both explain.
New alliances are now created that were unthinkable a few years ago. Enter the age of individual empowerment. In his latest book, “The Only Game In Town”, Mr. Mohamed El-Erian eloquently simplifies economics for the average of us and clearly why the economic T juncture is coming.
In healthcare, the current road with an approaching dead end was visible to many colleagues two plus years ago. Accusations of insanity and ridicule were the results. I was a believer before I was aware. Some may call it faith. It is better explained as “Effectual Entrepreneurship” as published by Stuart Reed, Saras Sarasvathy et al.
In recent weeks, and on an extremely small scale, the grand canyons were removed in our beta testing of our model. DHD and Ocean Surgery Center with the collaborative efforts of many have made the revelation real! Scaling, although it will be pursued, is not my specialty. Taking care of people’s health with quality, dignity and a known price is.