America's Bitter Pill

Last night as the 60 Minutes segment on health care started, my iPhone lit up with messages about getting my thoughts on the content.  That was easy; first, Steven Brill has little credibility with the misinformation and inaccuracies that appeared in his Time article about  two years ago.  Lucky for us, he is now shilling his new book with a similar title as the article, America's Bitter Pill.  

He needed to quickly hurry up and get the book released because, in the short term, it will be more useless than it is now.  Health care is changing as demonstrated by what health systems such as ours have been doing for the last four years.  Our focus has been on value-based care delivery, not generating as many tests, procedures, surgeries, admissions and ED visits as possible.  Volume-based care paid on a fee-for-service basis is quickly being replaced with incentivizing hospitals for keeping people healthy and out of the hospital.  America will start to see a sea change in the short term related to care delivery.  Everyone recognizes that spending almost $3 trillion on health care in the US annually is unsustainable, so new approaches like Maryland's Total Patient Revenue and Global Budget Revenue will be popping up all over the country.


As for 60 Minutes, I received information last week from the American Hospital Association on last night's segment.  AHA was asked to make someone available to be interviewed for the segment.  AHA in turn asked for a copy of the book since they took great exception to his Time article again due to misinformation and inaccuracies.  60 Minutes refused. AHA said in order to respond to charges made by Mr. Brill, having an idea of what was in the book critical of hospitals would have been helpful.  As a result, they declined.  

Using the Institute for Health Care Improvement's Triple Aim of Health Care reform (better care; healthier communities and reducing the cost of care), as well as the related components of the Affordable Care Act, hospitals across the country are focused on building healthier communities. Mr. Brill in his book glosses over what hospitals do each day in the care of our patients as did 60 Minutes.  They love to focus on the negatives that are quickly being addressed and eliminated as Jeffrey Romoff, the CEO of UPMC, stated during the segment.  

Mr. Romoff agreed to be interviewed for the segment since he, UPMC and his salary have been targets of Mr. Brill's since the Time article came out in 2013.  I thought that Mr. Romoff held his own during the segment and, quite honestly, he is the CEO of the largest non-government employer in Pennsylvania with 62,000 employees and almost $12 billion in revenues.  Mr. Brill likes to equate not-for-profit health care with your typical not-for-profit organization and that is not a fair comparison.  Health care is big business and, in UPMC's case, it's very big business.  Quite frankly, they do it well.  They are ranked 12th as one of America's top health systems.   

Hospitals continue to be an easy target for the likes of Mr. Brill and 60 Minutes; however, they had better get their licks in quickly because changes are a comin'.  Stay tuned.