Finding Value at the Intersection of Price and Quality

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By Allon Yosha

When I first entered the world of health care, it felt like a black box: so completely opaque that it wasn’t clear anyone could fully understand everything going on inside. My knowledge of insurance types, government regulations, and reimbursement methods was mediocre at best. My understanding of diagnostic equipment, imaging protocols, and physician qualifications was even less impressive. Opacity notwithstanding, I naïvely believed that everyone in the health care industry worked happily together in the name of patient care. Suffice it to say, the reality did not meet my expectations.

The “Business” of Health Care
Five years later, I’ve become much less naïve about the “business” of health care. The current paradigm by which payers cover costs, providers deliver care, and patients (attempt to) navigate the system is rife with misaligned incentives. Further, although the system is structured as a business, it operates in an environment often hostile to business success and must contend with varying state regulations, woefully outdated payment models, and the collection, maintenance, and protection of silos of sensitive data.

While many facets of this system require correction, one stands out above the rest: the difficulty of evaluating a physician’s skill in diagnosing and treating particular illnesses or injuries. It’s hard to quantify the quality of the diagnosis and treatment you receive. That’s a big problem for patients, payers, and providers alike.

Is Radiology a Commodity?

Read the full article on Radiology Today here.

Julian Yao