Healthcare has a churn problem
I was diagnosed with anorexia at 10 years old. Over the next several years, my family and I navigated a healthcare system that was mostly focused on how many days I stayed in a hospital bed instead of whether I was getting better. I spent my entire freshman year of high school in and out of facilities, counting down 45-minute therapy slots while fighting a brain disorder that forces you to battle…
Anorexia was diagnosed in the author at the age of 10. Throughout her life, she encountered a healthcare system that prioritized hospital bed occupancy rather than recovery. The author spent her freshman year of high school in and out of facilities, often counting down short therapy sessions while battling a brain disorder. Despite the numerous appointments, bills, and processed claims, her anorexia persisted.
Reflecting on her experience as a founder and CEO of an eating disorder treatment program, the author realizes the traditional healthcare business model is the same one that caused her struggles. In traditional healthcare, revenue is tied to the number of sessions, appointments, and the duration of treatment. This aligns with a fee-for-service model, which incentivizes more visits, longer stays, and higher relapse rates.
This model, akin to an auto repair shop charging hourly for unaddressed problems, is not conducive to sustainable success. The main issue lies in the alignment of industry interests. Fee-for-service models reward visit volume, leading to fragmented care. To address rising costs and demands, a shift towards value-based outcome models is necessary.
These models tie reimbursements directly to clinical and financial outcomes, providing flexibility for leaders to create better products benefiting all involved parties. For example, Equip, the eating disorder treatment program founded by the author, recognized that once-a-week therapy was insufficient for treating complex disorders.
By partnering with health insurance plans to develop value-based payment structures, they designed a treatment model involving a team of doctors, dietitians, therapists, and coaches delivered virtually. This approach ensures appropriate care is provided when needed, without disrupting daily routines or hindering the pursuit of a fulfilling life.
However, the healthcare industry has historically lacked a consensus on what "good" means, particularly in treating eating disorders where recovery is not as straightforward as medical tests or healing bones. Defining quality is particularly challenging due to the complex nature of these disorders. The field relies on tools like the EDE-Q and PARDI-AR to set severity thresholds, yet neither delves into what "getting better" truly entails.
Moreover, a long-term perspective is crucial, which can conflict with healthcare's budget cycles typically lasting 12-24 months. As a child, the author's stabilization of vitals in a hospital bed signified recovery, but subsequent cycles of treatment revealed that this doesn't equate to genuine healing. To tackle the national mental health crisis, an economic framework that aligns doing good with doing good business is essential.
By replacing the traditional model with outcome-based partnerships, healthcare companies can build efficient products that truly work, delivering on healthcare's fundamental promise: providing effective solutions. Kristina Saffran is the co-founder and CEO of Equip.
Written by urgent.news from Fast Company's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.
