Dr Ken Cohen Offers Possible Solutions to Reducing Wasteful Health Care

Creating new incentive models and transparently sharing data in a way that changes behaviors are 2 ways to reduce low-value care in the health care system, explains Ken Cohen, MD, director of translational research for Optum Care.

Transcript

How can we do a better job of removing low-value, wasteful care from the health care system?

The quick and easy answer is you stop paying for it. There’s not been a lot of will to do that, so, the question is: what else can you do? There's really 2 things. One is, you change how you pay specialists. So, 93% of the specialists in this country are strictly volume based, and that does not foster a value-based care environment. You need to build incentive models so that about a third to up to 50% of the revenue that a specialist makes is based on incentives for value-based care, for population health management, and not based for volume. It's a tricky thing to do, because the specialty incentive model needs to look completely different for each specialty. They have to be designed specialty specific. It's difficult, not impossible. We're actually hard at work doing that now.

The other thing that you can do is transparently share data. If you start measuring high-value care, and low-value care, and array that on unblinded transparent reports and share it both with PCPs [primary care providers] and specialists, 2 things happen. Number 1, PCPs start migrating referrals to high-value specialists. Number 2, the folks that are not high up on those lists begin to alter their care patterns so that they can preserve those referrals.

Both of those have actually turned out to be effective methods.