From "Providing Services" to "Meeting Needs"
The evolution of medicine presents us with a complex landscape. While we've witnessed remarkable advancements in therapeutic efficacy, we're also grappling with a healthcare system that has become increasingly impersonal, fragmented, and costly. This blog proposes a strategy to address these challenges by reframing our fundamental approach from "providing services" to "meeting needs" – a shift that could significantly improve healthcare delivery.
At first glance, the importance of meeting needs might seem self-evident. One might assume it's already the cornerstone of healthcare. However, historically, the focus has been on providing services, a model that served us well for many years. Traditionally, patients (a term rooted in the concept of "suffering") sought care for acute issues, which were typically addressed in one or a few encounters. In this context, providing services effectively met needs.
However, this conflation of services and needs is no longer appropriate in our current healthcare environment. Policymakers now recognize the broader societal impact of individual health, leading to a more "population-oriented" approach. This expanded view encompasses care for both symptomatic patients and those with asymptomatic chronic conditions such as obesity, diabetes, and frailty.
Moreover, the equation of services with needs has contributed to significant cost inflation. The well-intentioned provision of health insurance often pays for services without explicit links to value. This system incentivizes the provision of more services, particularly those with high profit margins, potentially misaligning service provision with actual patient needs.
On the demand side, we see patients requesting suboptimal services, often due to lack of awareness, misinformation, or influenced by marketing that may not align with their best interests.
I propose a shift in how we measure healthcare system output, particularly at the administrative level. By moving from units of service to units of met needs, using tools for population segmentation based on health and health-related social services, we could potentially alter cost inflation dynamics and promote meaningful innovation.
This approach extends beyond the "value-based healthcare" movement, identifying a key management strategy for implementation. It's also distinct from the potentially over-complex and manipulative "value-based pricing" at the micro-level.
In essence, the traditional equation of services with met needs is no longer sustainable in our modern healthcare landscape. We need a practical metric of met needs to serve as the foundation for organizing and funding healthcare.
In future discussions, we'll explore the root causes of our current dysfunction in using units of service, methods for measuring met needs, and the challenges we face in transitioning to this new metric of healthcare production. While this shift presents significant challenges, it offers the potential for a more effective, efficient, and patient-centered healthcare system.
