Imagine paying for health care based on how healthy you get.
American health care is a mess. Even with some of the most exciting technologies in the world we don’t have an efficient, functional medical system that lowers costs while also making people healthier. “Our system is designed around volume, not value,” as Harvard Business School’s Michael Porter tells Fortune in an interview.
But a consortium of top medical executives and thought leaders—including Porter, the CEOs of Medtronic, Kaiser Permanente, Novartis, and others—have joined forces under an ambitious World Economic Forum (WEF) and Boston Consulting Group (BCG) project determined to upend this status quo, starting with a a new experimental project for heart disease patients in Atlanta.
Fortune got a first look at WEF’s “Value In Healthcare” initiative and spoke with some of the key players endorsing a radical new approach to health care. And all of them agreed: revolutionizing medicine means the slow, painful work of figuring out what good health actually looks like (before proceeding to other, equally burdensome tasks).
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WEF’s value-based health project has been in the works for several years. Its goals include setting standardized baselines of what constitutes a “positive” health outcome; using this data to set benchmarks that medical providers should strive for; and resetting payment and reimbursement models to reflect these realities.
This is all easier said than done. But the consortium of influential figures that has come along to support this project is impressive considering how it blends ostensibly sworn corporate enemies together. In health care, the blame game is dominant: insurance companies say high costs are drug makers’ and hospitals’ fault; pharma companies point the finger at insurers and benefit managers. It’s a never-ending carousel of “pass the buck.”
“If there’s one place where [WEF] can play a role, it’s in value-based healthcare,” Arnaud Bernaert, one of WEF’s executive committee members, told Fortune in an interview.
In fact, the WEF project’s executive board members—which include pharma giant Novartis CEO Joe Jimenez and Kaiser Permanente chief executive Bernard Tyson, whose business centers on doctors and hospitals—present the exact sort of bedfellows the group thinks is sorely missing in health care.
Greater collaboration could mean a heart failure patient’s future isn’t determined by the inefficient fee-for-service model that dominates the U.S., but rather on a system where medical providers are rewarded for actually improving your health. One of the major pilot projects under the new WEF initiative is centered on coordinating care among such heart failure patients in Atlanta; it will incorporate medical providers, government agencies, and industry alike (you can read the full WEF project launch report here).
All of this may sound obvious—of course health care should be based on results rather than the number of tests someone is pushed to get!—but it’s not the case in America. Adversarial business units hoard their information; health care is approached incrementally rather than with the holistic hammer needed to truly change the sector.
But the new WEF initiative participants believe its global nature can help establish a turning point (the UK’s National Health Service CEO and the Netherlands’ Minister of Health, Welfare, and Sport are among the other executive board members for the project).
“We need to eliminate some of the silos in healthcare systems and spending, reduce waste, and take a more holistic approach to resource allocation, centered on the value delivered to patients,” as Novartis’ Jimenez puts it.
Making that dream a national and global reality? The players have their work cut out for them.