5 thoughts from Kaiser Permanente CEO Bernard Tyson on the future of US healthcare

Bernard J. Tyson, chairman and CEO of Oakland, Calif.-based Kaiser Permanente recently told Fortune he is more optimistic about the U.S. healthcare system now than ever been before, despite the possible dissolution of the Patient Protection and Affordable Care Act and other challenges.

While Mr. Tyson believes the future of healthcare is looking up, he did point out some issues that pose obstacles. Here are five key points from Mr. Tyson's conversation with Fortune.

1. Medical institutions must shift focus from inputs to patient outcomes. Physician incentives and the fee-for-service model has been "all wrong" for developing a more affordable and effective system because of their emphasis on volume of services provided instead of value, according to Mr. Tyson.

Instead, to encourage an emphasis on value, at Kaiser, provider teams led by physician "quarterbacks" are paid with a flat salary and receive end-of-the-year bonuses if their patients have better health outcomes. According to Mr. Tyson, Kaiser's patients under the age of 65 have substantially shorter inpatient hospital stays compared with the same population in other U.S. health systems.

2. Changing the way individuals approach their health will change the healthcare system. According to Mr. Tyson, America's healthcare system today is a "fix-me system" in which patients seek hospital care when they are already ill. This approach is expensive and often too little too late in terms of medical interventions.

In changing the structure of incentives to reward the value of care and population health, medical professionals can become stronger advocates for people in making positive behavioral choices that will influence their health. Kaiser's providers focus on diet, exercise, tobacco and alcohol use in discussions with patients, and deliver them with a "medical spin" that is effective in communicating their importance and getting patients to take their recommendations seriously, according to Fortune.

3. Embrace email. With a greater push toward population health management comes a greater responsibility for physicians and other providers to maintain more regular communication and support to patients in between and ahead of office visits. While this may seem like an expensive project, it doesn't have to be.

According to Fortune, in 2014, Kaiser's physicians conducted approximately 13 percent of the system's medical appointments, 20 million appointments, as e-Visits via email. Mr. Tyson told Fortune he expects this number to grow. Kaiser is investing in video-conference technology that will improve the delivery of healthcare through digital check-ups, and patients have voiced satisfaction with it so far.

4. The U.S. must make interoperability a top priority. Mr. Tyson identified interoperability — or the lack thereof — as one of the U.S. healthcare system's biggest inefficiencies. While the implementation of EHRs has the system taking steps in the right direction, too many hospitals don't even have these capabilities yet, effectively rendering them as patient information islands.

5. The cost of drugs poses a major hurdle for progress. New medical research leading to more effective treatments for various complex conditions, though a remarkable advancement, poses a huge challenge in healthcare because the cost of specialty drugs is so high that patients often can't afford them. At a system level, the cost of these drugs is unsustainable, Mr. Tyson told Fortune.

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