Bob Kocher was Wrong
Robert Kocher MD was the only physician on the President’s National Economic Council in 2009.
He was one of the architects of health care reform—the ACA.
He has publicly stated it was his intent for the law to force consolidation in healthcare delivery, believing it would enhance efficiencies and promote scaling of the most effective practices.
He now says he was wrong.
He openly acknowledges what five years of research into health care reform has revealed. As summarized on the Harvard School of Medicine website: independent, smaller, primary-care-based practices innovated sooner and more effectively than larger integrated systems.
This finding is hardly surprising to those of us who have delivered primary care in both worlds. Because of Dr. Kocher, we’ve been forced to live it.
It is to his great credit that he, at least, has admitted his error.
His hubris has done great damage.
How to undo it?
Recreate those small practices within your own organization.
Back off the factory model of healthcare delivery and allow your primes to provide care the way they’re trained. As indicated by their increasing disengagement, they’re begging for the opportunity.
Finance your transition by risk-sharing the attributed revenue of programs such as Medicare Advantage. Train them to do it well.
You’ll find your clinicians engaged, your reputation enhanced and your patients thrilled.
You know the fee-for-service treadmill is going to collapse under it’s own weight. Your own primes are waking up to the fact that there are better way to practice medicine. If they’re not yet leaving you physically, they’re checking out emotionally.
The opportunity and resources to get ahead of the curve are waiting to be picked up.
Innovation is now the only safe choice.
Bob Kocher was wrong on the Accountable Care Act.
You don’t have to be.