True payment reform will need to occur soon, physician says

A doctor discusses the rising healthcare costs across America.

Vanessa Hill, MD, serves as the medical director at the Children's Hospital of San Antonio and as a physician adviser at Irving, Texas-based Christus Health. 

Dr. Hill will serve on the panel "Key Strategies to Build Data Science Teams That Bolster the Bottom Line" at Becker's 7th Annual Health IT + Revenue Cycle Conference. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference, which will take place Oct. 4-7 in Chicago. 

To learn more and register, click here.

Question: What are you most excited about right now?

Dr. Vanessa Hill: I'm hopeful that the SARS-CoV-2 pandemic will continue to become a more endemic infectious disease; with that, enable us to move forward to begin aggressively addressing some of the glaring deficiencies in our healthcare system. I'm excited to see how technology, data utilization and health information networks can play a role in these shortcomings. Costs of care, care continuum transitions and novel payment models likely will work their way to the top of the U.S. healthcare priority agenda. It will be an exciting time in medicine to finally see how we can come together and solve some of these issues and place patients at the center of our efforts as we enact change.

Q: What challenges do you anticipate over the next two years?

VH: It does seem that the U.S. is now at or approaching a tipping point with the rise in healthcare costs. True payment reform will need to occur soon; better rewarding or accounting for healthcare outcomes and efforts related to value. There needs to be a shift in accelerating research funding that focuses on clinical outcomes to guide this significant directional tack. These ideas are not new in 2022, but many believe the U.S. will be forced to drastically move in a direction soon to begin to curb this trajectory. We have taken the first step with federal rules requiring healthcare organizations to be more transparent with pricing. Variations in pricing, fragmentation and complexities in how healthcare services are paid make the current healthcare system untenable. Employers, patients and CMS as healthcare consumers should continue to demand that healthcare organizations comply with this rule. Ultimately, consumerism should drive value.

Q: Where are the best opportunities for disruption in healthcare today?

VH: Patient or consumer-facing price and quality transparency tools which allow for or steer enrollees away from high-priced, low-value hospitals and hospital systems and encourage using systems with value-driven outcomes. Employers and CMS must shift payments to higher-value care. Consumers must begin to demand quality.

Q: How is your role as CIO evolving? How are IT teams changing?

VH: I am not a CIO; I was a CMIO a few years ago. IT teams have now evolved to integrate many clinical professionals into their day-to-day operations and product development. Unfortunately, we missed this boat when most electronic health records were developed. We've come full circle now, and many systems and corporations value clinical doctors, nurses or other healthcare associates as content experts and leaders bringing better value to the IM/IT arenas.  

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