The Business Case for Quality:
A Unified Field Theory Applied to Health Care
New payment model explicitly consistent with UFT-A principles has
been developed! Click
here for more information.
The need to improve quality in the American
health care system has never been more urgent. With health
insurance
reform now a
reality, the need to deliver better healthcare value is even
greater. The legislation reflects that current initiatives,
including "pay
for performance" programs, are not yet generating enough
improvement in health care. A major reason is the failure of
policy, markets
and regulation to engage physicians, arguably the most significant
drivers of what care is delivered. James
L. Reinertsen, M.D.
and Alice G. Gosfield Esq.,
have joined in a project which unites their
unique backgrounds, expertise and perspectives in an effort to
improve health care through a stronger business case for quality
that will engage physicians. Our original proposal posits how
to use clinical practice guidelines to drive
physician payment and
many other aspects of the health care system. Our theory is set
forth in a major white paper, "Doing
Well by Doing Good: Improving the Business Case For Quality" which
offers five
core principles which can revolutionize health care
delivery by creating a unified approach
to payment, documentation, billing, institutional organization,
and more through evidence based medicine and patient-centered
care. These principles are also directly relevant to efforts
at clinical
integration and collaboration by physicians with each other,
as well as across the delivery continuum. Physician engagement
and
clinical integration around quality will be essential to fulfill
the expectations of the many quality improvement initiatives
in the health reform legislation. Pressures from health reform have made it clear that physician engagement around quality and now-- far more intensely—value will be essential for physician success and survival as well as for the success of their significant clinical partners – hospitals and health systems. We have written a new white paper, "
", which calls on physicians to clinically integrate with each other.
This website was launched in 2003. Some progress
has been made on the issues we address. The five principles
we published
then
remain relevant in the new and fast changing environment which
will require physicians - and those who seek their engagement
- to step up and proactively change the way care is delivered.
standardize to the science as much as
possible;
simplify the system and processes to give
time back, particularly to physicians;
make administrative processes as clinically
relevant as possible, beginning with a clinically
relevant payment model;
engage the patient around the science
and the processes of care;
fix accountability at the locus of control
for reporting and measurement.
Physician engagement around quality is still a critical challenge.
The challenges of broader, improved clinical collaboration
to produce better quality, more efficiently, can be met.
This website,
a listserv,
our publications, speeches, available presentations and
consulting are intended to facilitate applying our theory
and the five
principles (a “Unified Field Theory –Applied”) UFT-A toward
that end. We encourage you to explore our website and consider
how we can improve health care through this work. We welcome
your participation in this dialogue.