The conversation about transitioning the American healthcare system from fee for service (FFS) to value-based care (aka, pay for performance) has been going on for more than 15 years. Still, it felt like time travel to come across a Health Affairs book review from 2006 by the late Princeton Professor Uwe Reinhardt that could have been written last month.
In evaluating what he describes as the “utopian vision” laid out in Michael Porter and Elizabeth Teisberg’s Redefining Health Care (a title, by the way, that can be recycled without penalty just as soon as the previous use has fallen out of the public memory), Reinhardt identifies a fatal flaw: Explaining what American healthcare should do to better treat patients without touching on how it might be accomplished.
“Unfortunately, [the authors’] book offers few practical hints on how the U.S. health system would transit from its current, allegedly negative-sum game to the allegedly positive-sum utopia [the authors] envision,” Reinhardt says. “That transition would vastly rearrange the distribution of economic power and clinical autonomy in our health system. It is naive to assume that the potential losers in that transition would simply roll over and accept their fate.”