By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: New Healthcare Models Stand “Standard of Care” on Its Head
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Policy & Law > Health Reform > New Healthcare Models Stand “Standard of Care” on Its Head
Health ReformMedical EthicsPolicy & LawPublic Health

New Healthcare Models Stand “Standard of Care” on Its Head

Caroline Popper
Caroline Popper
Share
4 Min Read
SHARE

As I watch the power in healthcare shift away from physicians/providers toward consumers/patients (enabled by the wide access to information and driven in part by higher co-pays), I can’t help but to observe the affects of the Affordable Care Act on both this new power and the bedrock concept of healthcare delivery—“standards of care”.

As I watch the power in healthcare shift away from physicians/providers toward consumers/patients (enabled by the wide access to information and driven in part by higher co-pays), I can’t help but to observe the affects of the Affordable Care Act on both this new power and the bedrock concept of healthcare delivery—“standards of care”.

Rob Lamberts, a physician who switched his practice from fee-for-service to “direct care” (in which patients buy in as a member instead of paying for each procedure and visit, and receive a basic set of services), has compared the changes in healthcare delivery to the upheaval caused by digital cameras. Just as the move from film to digital imagery brought photography closer to the consumer, mobile apps and web-accessible information will move healthcare delivery closer to customers (a.k.a., patients). Film companies like Kodak failed to recognize the disruptive innovations wrought by digital photography; could consumer power provide the same disruptive innovation to healthcare? As healthcare industry expenses approach 18% of GDP, the unsustainable weight of healthcare costs practically beg for such a disruption.

The Affordable Care Act (ACA), as well as other regulations and pending legislation, is addressing healthcare delivery standards and relating those standards to costs. The ACA will require health plans to be delivered at four levels of coverage: bronze, silver, gold and platinum. Bronze plans will require the highest copayments, and platinum the lowest. All, however, will have to cover basic benefits such as ambulatory services, emergency care, hospitalization, maternity/newborn care, mental health, prescription drugs, rehabilitation, laboratory services, prevention and wellness, and chronic disease management. At the same time, high-end concierge services—the so called “Cadillac health insurance”—will be subject to a 40% tax.

More Read

(Crowd)Funding Patients to Attend Medical Conferences?…Now That’s a Great Idea
Mobile Health Around the Globe: ‘Wazazi Nipendeni’ Free SMS Service Launches in Tanzania
Extending the Frontiers: Working Despite Alzheimer’s and Campus Smoking Bans
The Best Investments To Make In Your Health This Year
Health Reform Calendar 2012

The sheer size of the plans under the ACA will require more standardization of insurance coverage, and new and potentially different concepts of “standards of care.” I believe we will see the basic package become the core “standard” with more costly but more generous premium services layered on top. And we will see a rapid shift from fee-for-service to global payments for various levels of service intensity.

But can you also have too much health care? Standards of care, developed by professional organizations, have traditionally answered this question. With these new levels of care, standards are no longer decided exclusively by physicians and specialists’ organizations; they’re increasingly influenced by patient choices. So the concept of guideline-driven medicine may no longer be in the eye of the physician but in the eye of the policy-holder.

Is the U.S. consumer ready for so much service choice? Where does the responsibility for consumer education fall? What mechanisms should we put in place to measure quality and reward efficient providers? Let us know what you think.

Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

Epidemiological Health Benefits
Personal and Epidemiological Health Benefits of Blood Pressure Management
Health
October 13, 2025
Traumatic Brain Injuries
Understanding Traumatic Brain Injuries: What Families Need to Know
Policy & Law
October 10, 2025
Remote Monitoring touchpoints
Remote Monitoring Touchpoints Patients Will Actually Follow
Technology
October 9, 2025
dental care
Importance of Good Dental Care for Health and Confidence
Dental health Specialties
October 2, 2025

You Might also Like

22 Days into Implementing KY’s “Emergency” Narcotic Regulations

August 12, 2012
healthcare technology
BusinesseHealthFinanceHealth ReformMobile HealthPolicy & LawTechnology

Technology May Make Capitation in Healthcare Work

July 31, 2013
Public Health

Hologram or Avatar Doctors: Why They Will Never Happen

April 11, 2013

IT Strategy for Health Plans: Interview with ikaSystems CEO Joe Marabito

August 11, 2014
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?