Let’s keep the discussion going that I started months ago. This series will be about how we align health
economics with good patient outcomes. Love to hear your thoughts!
Good care pays off for years. Almost nobody in healthcare gets paid for it.
I run a home medical equipment company. Here’s what that looks like on the ground. A COPD patient
goes home on oxygen. If we do our job right, fast setup, working equipment, real follow up, that patient
stays out of the hospital. And every hospital stay they avoid protects their lungs, which makes the next
one less likely too. The benefit stacks up year after year. Keeping someone healthy today makes them
healthier and cheaper to care for tomorrow.
So why doesn’t anyone invest in it? Three reasons.
The clock. The payoff from good care takes 10 to 20 years to show up. Private equity plans to sell in 3 to 7.
Public companies live quarter to quarter. Nobody’s calendar runs long enough to collect.
The wrong wallet. When my company spends money keeping patients healthy, who saves? Not us.
Medicare saves. The hospital saves. The insurer saves. The company that spent the money gets nothing
back. Sometimes we lose revenue for doing it.
It’s invisible. When a healthcare company sells, buyers look at revenue and profit. There is no line on the
books for patients we kept out of the hospital. So the thing that matters most never gets built, because it
never shows up in the price.
Now look at the few organizations that actually made keeping people healthy into a business. They all
have three things in common. They’re on the hook for the total cost of care, so a healthy patient is worth
more to them. They keep patients for decades, so today’s prevention pays them back. And they don’t
answer to Wall Street every 90 days.
What’s not on that list? Who owns them?
That’s the real lesson. The problem isn’t that the wrong people own healthcare companies. It’s that the way
we pay for healthcare punishes every owner, big or small, public or private, for doing the right thing.
Fix the payment system so keeping patients healthy is profitable, and watch how fast every owner starts
doing it.
Any thoughts on how to align this so everyone wins?