Compete on value, not cost-shifting
Porter argues US health care competes at the wrong level, shifting costs among payers and providers instead of creating patient value. Redirecting competition to value fixes the incentives.
Redefining health care
6 ideas
Value equals outcomes per dollar
Value is defined as health outcomes achieved relative to the cost of the full care cycle. This metric, not volume or price, should govern the system.
Compete at the level of medical conditions
Care and results should be measured and compared for specific conditions over the full care cycle, not for discrete procedures. Outcome measurement at this level enables real competition.
Integrated practice units
Providers should organize around a patient's medical condition with multidisciplinary teams rather than by specialty department. Structure follows how value is created.
Outcome measurement is the key lever
Mandatory, standardized reporting of risk-adjusted outcomes lets patients and payers reward high-value providers. Transparency drives the whole reform.
From zero-sum to positive-sum competition
Current competition redistributes a fixed pie while value-based competition expands it by improving outcomes and efficiency together. The goal is to change the game.