Executive Summary

The Brave New World Of Health Care

Andy Czajkowski
President & CEO of Blue Cross & Blue Shield of Minnesota

September 1993

We are now entering the brave new world of health care. In this new world, information is king. It will be shared among healthcare payers, medical professionals, purchasers, and, of course, consumers. Cooperative ventures between payers and providers will improve healthcare quality and control its costs. Consumers will be better informed users of the healthcare system and better served because they will have more information to make decisions.

For years, healthcare payers and providers have worked together by negotiating contracts for pricing, but have not worked together in cooperative business arrangements. In this brave new world of health care, payers and providers will work more closely together in long-term partnerships or joint ventures.

They will share common visions, goals, and clinical data to help reform the healthcare system. These new ventures will give each party a vested interest in health care, because both payers and providers will be sharing the risks.

Computers and electronic technology will continue to play an even bigger role in this new world. Besides processing millions of claims each year, computers will also help clinics and hospitals conduct other routine business transactions--such as verifying patient eligibility and checking the status of claims--electronically. By transferring medical records electronically, technology will streamline this part of the process and continue to move payers and physicians toward a totally paperless communication system. Reducing the need for paper work will be an important element in lowering the cost of health care. By some estimates, 40 percent of the staff in a typical doctor's office is dedicated to administrative work.

Equally important, however, is how data and computer systems help to improve the practice of medicine and, in turn, the health of patients. By using these systems, physicians can share clinical data and improve healthcare outcomes.

In this brave new world, information shared by physicians and purchasers enables them to make changes for the better. This information provides an excellent picture of the cost and quality of healthcare services, allows physicians to improve the quality of the health care they deliver, and gives employers information to make wiser healthcare buying decisions.

Consumers will be more active in making healthcare decisions and will achieve better results because of their involvement. But they won't be making the decisions alone. Payers and providers will share information with them so they can make the best decisions. With interactive videos, patients can review various scenarios to find out the benefits and risks of given procedures or treatments.

The brave new world of health care will bring changes that will mean cooperation, shared information, and streamlined administration. It will make the system better for everyone.

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