Comments on Healthcare X PRIZE: Measuring Health Value - Shifting the Paradigm

Audrey, Thanks for your input. We are finding th...

2009-06-02T14:52:43.785-07:00

Audrey,

Thanks for your input. We are finding that part of the "good fight" is to help educate individuals around what health value actually means and what health outcomes we should be wanting to achieve.

We want people to be guided, advised, or steered to providers who deliver high quality outcomes at low costs. We want people to understand that they can and should be accountable for their own health and behaviors. We would love to see health payment be utilized to reward best choices by patients, providers, and others within the system.

I will look forward to reading your information on health value.

This is a lot like taking a huge Economics 301 Fin...

2009-06-02T11:44:48.178-07:00

This is a lot like taking a huge Economics 301 Final Exam. There are so many variables to discuss, variables to define and other items that must be measured. The X Prize program seems aware of these challenges, however, there still needs to be more discussion on the meaning of 'value'. How will people spend their health care dollars in this economy in an attempt to better the health value in their community? Will they participate? Are they altruistic at all? Will they become more empathic as the recession abates?

These and other questions are some we considered in doing the Spectrum Health Value Study. Results of our preliminary findings can be found at www.healthvaluestudy.com. Also, we were just accepted for an oral presentation at the APHA meeting in Nov in Philly. You can follow us on Twitter at HealthValue.

Facts won't change peoples' behavior but feedback ...

2009-06-02T09:36:32.590-07:00

Facts won't change peoples' behavior but feedback of performance will let those motivated to change obtain knowledge of results.

The motivation to change might be government payments for higher performance scores.

The payments could be in the form of tax credits.

The technology exists to measure many of the validated self-report measures by e-mail sent directly to the individual.

"Health" is a poorly defined construct that has a low present value to the majority of Americans.

"Sickness" is currently the driver of demand for our health care market.

Could some government stimulus be directed to tax credits for healthy, measurable improvements in self-report and performance scores on the IVS?

Tim
TimRichPT@PhysicalTherapyDiagnosis.com
www.PhysicalTherapyDiagnosis.com

Anonymous, You make a great point which I probab...

2009-06-01T23:15:02.096-07:00

Anonymous,

You make a great point which I probably did not highlight enough in the measurement. The top 5% of patients are responsible for ~50% of expenses. If we were to go after just those patients, we could begin to "bend the curve."

However, I believe it is the people under the "long tail" part of the curve that we can also begin to impact as well by changing the culture of health and our notions of health. This is obviously a longer slog - and fortunately - 50% of people are not costing us too much money right now which gives the education an opportunity to have an impact.

I share your opinion that highlighting the facts won't change behaviors (smoking is a great example). However, I also believe that tying those bad behaviors to their real financial costs will (Safeway Health is a great example of this!)

It might be interested to see how people and commu...

2009-06-01T23:06:38.179-07:00

It might be interested to see how people and communities score now as well as what percentage of health is really under our control.

We all know the impact of lack of exercise and obesity but data alone doesn't become knowledge nor change behavior. People who smoke are well aware of the risks to their health but continue.

We all wish that telling people their numbers would somehow result in different behavior but that fails to grasp the complex intervention that is required for behavior change. Even if everyone was to stop smoking, maintain a healthy diet (assuming they can afford it) and exercise how much of health care costs would be reduced?

Most studies show that 10% of people with chronic conditions account for 70% of the costs so why not start there instead? Seniors should be the target not the healthy wealthy.