Redefining Health Care Quotes

“But history tells us that monopolies that are truly benevolent and effective are rare.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“When providers have to compete on results, the problem of supply-driven demand, in which available capacity leads to care with questionable benefits, will largely disappear.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“Standardized process guidelines belie the complexity of individual patient circumstances, and freeze care delivery processes rather than foster innovation. What is needed is competition on results, not standardized care. What is needed is competition on results, not just evidence-based medicine. There should be no presumption that good quality is more costly.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“Competition has taken place at the wrong levels, and on the wrong things. It has gravitated to a zero-sum competition, in which the gains of one system participant come at the expense of others. Participants compete to shift costs to one another, accumulate bargaining power, and limit services. This kind of competition does not create value for patients, but erodes quality, fosters inefficiency, creates excess capacity, and drives up administrative costs, among other nefarious effects.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“U.S. consumers report higher dissatisfaction with their health care system than do consumers in other developed nations.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“Per capita health care cost in the United States surpasses that of most other developed countries. Despite this, U.S. costs are rising at comparable rates.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“THE U.S. HEALTH CARE SYSTEM is on a dangerous path, with a toxic combination of high costs, uneven quality, frequent errors, and limited access to care.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“Many countries have state-dominated or state-run systems with little competition. Their historically lower costs and favorable mortality statistics have led some to advocate that the United States move to emulate them. Yet other advanced countries are now facing accelerated rates of cost increase similar to those in the United States, while new evidence is revealing alarming quality problems that appear to be as bad as or worse than the U.S. experience. Leaders in many other countries are now questioning the future structure of their health care systems.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“About half of employer-provided health plans in the United States are self-insured plans, giving employers even more latitude in designing and administering such plans.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“Moving to value-based competition on results will require significant changes by all system participants, as we have noted. However, the system can, and will, change from within. Each system participant can significantly improve value, and reap the benefits, even if nothing else in the system changes.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“How to create competition on results throughout the system, and the kinds of information that need to be measured, analyzed, and disseminated, appear as recurring themes throughout this book.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“Consumers will only be able to play a bigger role in their care, and make better choices, if providers and health plans realign competition around patient results and disseminate the relevant information and advice.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“Pay-for-performance will only raise costs if providers get higher pay for process compliance but do not have to compete on results.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“Good quality is less costly because of more accurate diagnoses, fewer treatment errors, lower complication rates, faster recovery, less invasive treatment, and the minimization of the need for treatment. More broadly, better health is less expensive than illness.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“Rather than measuring results and rewarding excellent providers with more patients, the focus has been on lifting all boats by attempting to raise all providers of a service to an acceptable level. The principal tools have been practice guidelines and standards of care that every provider is expected to meet. Evidence-based medicine is another term for practicing based on accepted standards of care.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“Mandatory measurement and reporting of results is perhaps the single most important step in reforming the health care system.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“Competing on results requires that results be measured and made widely available. Only by measuring and holding every system participant accountable for results will the performance of the health care system ever be significantly improved.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“Competition on value must revolve around results. The results that matter are patient outcomes per unit of cost at the medical condition level.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“The local bias in health care means that many providers offer services in which they lack the volume and experience to be truly excellent, and that excess capacity and the tendency for supply to create demand are almost guaranteed.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“competition in the current system is too local, because it is centered on relatively small, self-contained local institutions catering to local needs. Services are both delivered locally and managed locally. The local bias in health care is a throwback to an earlier era when medical care was less complicated, and travel more difficult. It has been institutionalized by prevailing ownership and governance structures for provider institutions, regulatory and reimbursement practices, and a lack of local provider accountability for performance.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“competition takes place on discrete interventions rather than the full cycle of care where value is determined. Value can only be measured over the care cycle, not for an individual procedure, service, office visit, or test. Yet care is structured around medical specialties and discrete services, not the integrated care of medical conditions. Physicians act as free agents, performing their specialty and billing separately. Navigating the care cycle is challenging. Nobody takes an overall care-cycle perspective, including steps to avoid the need for interventions (prevention) and ongoing management of medical conditions to forestall recurrence (disease management).”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“Competition takes place on broad service lines, not individual services. Providers offer every possible service, and gear up to handle any patient who walks in the door. Health plans contract with providers across the board. Yet breadth of services per se has little impact on patient value—it is the ability to deliver value in each medical condition that matters. Health plans and providers have merged and consolidated, but the pursuit of breadth and the duplication of services have only increased. As system participants compete on breadth, competition at the medical condition level has been suppressed or eliminated by health plan networks, captive referrals within provider groups, and the almost total absence of relevant information.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“Competition in the current system is at the same time too broad, too narrow, and too local.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“Value in health care is determined in addressing the patient’s particular medical condition over the full cycle of care, from monitoring and prevention to treatment to ongoing disease management.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“At the most basic level, competition in health care must take place where value is actually created.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“The way to transform health care is to realign competition with value for patients. Value in health care is the health outcome per dollar of cost expended. If all system participants have to compete on value, value will improve dramatically.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“The only way to truly reform health care is to reform the nature of competition itself.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“The failure of competition is evident in the large and inexplicable differences in cost and quality for the same type of care across providers and across geographic areas. Competition does not reward the best providers, nor do weaker providers go out of business. Technological innovation diffuses slowly and does not drive value improvement the way it should; instead, it is seen by some as part of the problem. Taken together, these outcomes are inconceivable in a well-functioning market. They are intolerable in health care, with life and quality of life at stake. They are unsustainable in a sector that consumes a large and growing portion of the national budget.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“The fundamental problem in the U.S. health care system is that the structure of health care delivery is broken. This is what all the data about rising costs and alarming quality are telling us. And the structure of health care delivery is broken because competition is broken. All of the well-intended reform movements have failed because they did not address the underlying nature of competition.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results

“From a strategic perspective, however, the issues in health care can be divided into three broad areas. The first is the cost of and access to health insurance. The second is standards for coverage, or the types of care that should be covered by insurance versus being the responsibility of the individual. The third is the structure of health care delivery itself.”
― Michael E. Porter, Redefining Health Care: Creating Value-based Competition on Results