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Copyright © 2012

People, Places, Processes & Products that Influence the Supply Chain

 
 

INSIDE THE CURRENT ISSUE

July 2009

Fast Foreword

Flush with red herrings

Payers and providers alike volunteered to hold the line on price increases for a decade to aid President Barack Obama’s healthcare reform plan.

Obama called this photo op of unity a "a watershed event." Unfortunately, it’s nothing more than unfulfilling political theater thinly disguised as policy masking a "Waterloo."

Shame on them.

If this is all it takes to sift $2 trillion from the budget over a 10-year period then why didn’t these two "warring" factions offer this "solution," say, back in 1993 when President Bill Clinton and his wife were trying to solve pretty much the same healthcare crisis? It’s not as if the fundamentals changed that much in the last 16 years, save for another seven million allegedly added to the uninsured rank-and-file.

Only the warring faction players changed to a degree as a consolidation wave gripped the industry, dissolving brand names into larger corporate entities in an effort to cut costs, consolidate power and influence the effects of government intrusion in capitalistic free enterprise.

Yet within days of the much ballyhooed Camp David-like Accord on the White House lawn, the participating payers and providers balked and back-pedaled their way around the semantics and syntax. Something about overstating their cost-control commitments. They clearly joined President Clinton’s "depends on what the meaning of ‘is’ is" legal reasoning.

Barely two weeks passed before some swift legal minds went public with antitrust arguments that will gum, and not grease, Obama’s healthcare reform efforts. Apparently, some forgot that "any agreement among competitors with regard to prices or price increases – even if they set a maximum – would raise legal concerns," a former Federal Trade Commission official told the media. This is called collusion, but apparently it doesn’t rise to the level of, say, White House administration officials neglecting to pay their taxes.

Some industry observers started connecting dots, envisioning attacks on group purchasing organizations (GPOs), integrated delivery networks (IDNs) and shared service operations. But that’s unlikely. GPO activities already earned a hairball-sputtering cough and a casual dismissal from a Senate subcommittee. Plus, GPO and IDN business maneuvers represent chump change next to those blockbuster physician relationships with drug and/or implant companies.

Imagine, however, if these arguments somehow impact the product data standardization and synchronization or chargemaster-item master unification movements among hospitals and IDNs? So much for information technology saving the day, eh?

Let’s roll the highlight reel, shall we?

At the line of scrimmage, and before punting to his Congressional offensive line, Quarterback Obama called an audible in that any healthcare reform plan must keep costs in check, guarantee choice among providers and payers and make sure everyone has access to affordable coverage.

Employers may foot more of the bill (General Motors is cringing) as well as individuals who would be required to obtain coverage. But this notion of universal coverage sounds suspiciously like non-stock inventory. Let’s be honest: If you walk into an emergency room without insurance, you’re cared for and that care is expensed out to someone else. So much for this ethereal plight of the uninsured and underinsured.

A new study released in mid-May in the journal Health Affairs showed that doctors spend between $21 billion and $31 billion a year (administrative costs) haggling with payers about a variety of issues, including claims and formularies.

So healthcare IT should solve the problem, right?

Another study, released earlier last month, indicated that more than half of all healthcare providers "believe the billions of dollars from the American Recovery and Reinvestment Act (ARRA) earmarked for healthcare information technology will have little to no success in encouraging HIT adoption." And yet another finds apprehension and reticence among providers to adopt IT for various reasons (read: fiscal and operational pain and suffering).

At best, IT adoption and implementation only would automate the chaotic administrative process that haunts the relationship between patient, provider and payer. At worst, it would reveal how revoltingly ugly and infected with error, malfeasance, negligence and waste the process is.

So look for the cinematic nest full of red herrings, "Health Scare Reform: A False Hope" to bypass theaters this summer and head straight to DVD in a market clamoring for Blu-Ray.