Comments on The Lean Way Consulting: Rethinking Value Streams In Healthcare

All of us needs a guidance. Even though we are too...

2011-08-26T01:49:12.463-05:00

All of us needs a guidance. Even though we are too old for it, we should know when is the right time to consult an expert for some of a point. Learn to accept the fact that all of us don't know everything in life.

Lean consulting has always struck me as a poor des...

2011-07-31T04:55:12.889-05:00

Lean consulting has always struck me as a poor descriptor for the work we do. Ironically the definition and standards around lean are still quite loose. The term has existed more for marketing reasons than because it is well-loved. "Lean" is pithy if not descriptive in this context meaning roughly "getting more from less" rather than "having less fat" in comparison to something less lean. Living in lean times has quite the opposite feel than "living in good times" although admittedly there is often more waste in good times.

Mark, Great points on how hospital systems are inc...

2011-04-01T09:23:27.050-05:00

Mark,
Great points on how hospital systems are incentivised. I think another approach might be consolidation with health systems and private practices basically making an ACO but with one owner. I believe they are doing something similar in Holland and they are actually reducing the number of major hospitals. The idea being better care through quicker management of conditions at the primary care level to stop big issues from happening.

Regardless there is a lot of opportunity around evaluating what the patient really finds valuable.

Ankit

You're right that hospitals risk their own rev...

2011-04-01T07:42:37.661-05:00

You're right that hospitals risk their own revenue by working on preventing admissions. It's the right thing to do for patients... I think this is where CMS and their new approaches with Accountable Care Organizations are supposed to help address that conflict by sharing savings with hospitals.

That inherent conflict isn't there in a structure like Kaiser where you are insurer and the hospital and the primary care org all in one. Incentives are aligned to ideally do more preventive primary care to reduce hospital costs... or even an org like Group Health Cooperative that is insurer and primary care (no hospitals) has good incentive alignment around reducing costs through BETTER care (as opposed to lower costs by denying care).