Having posted over 25 related climate and health-related interviews over the past several years, podcast listeners are aware that the healthcare industry effectively exists in a harm-treat-harm cycle where providers cause patients harm via their greenhouse gas (GHG) pollution - that requires treatment causing providers to emit more harmful GHG pollution added - that leads to more patent harm - that leads to . . . . In September I posted an article that appeared in Health Affairs in which I argued CMS design a Medicare Part A hospital Value Based Payment program and a similar program under Medicare’s Part B physician Quality Payment Program that financially incent healthcare providers to reduce their GHG emissions. Doing so, I argued, would measurably lower Medicare and Medicaid beneficiaries burden of disease, improve their care outcomes and safety, advance health equity, improve the industry’s financial sustainability and help heal the planet. Reforming insurance payments is also the interest of the Dutch healthcare policy researcher, Dr. Jeroen Struijs, who is presently in the US working with Harvard faculty to identify insurance value based purchasing methods that can incent the health care industry to reduce its GHG pollution.
During this 33-minute interview, Dr. Struijs begins by providing an overview of his research work. The discussion moves on to Dr. Struijs explaining what's driving aligning payments with industry greening and the lack of effort to to date by insurance carriers to align payments or reimbursement despite inherent efficiency motives. He identifies possible reasons why insurance carriers have not to date aligned payments, discusses the role or importance of development and use of sustainability quality metrics and patient incentives. Regarding financial incentives, he identifies opportunities via the Part B Medicare Shared Savings (ACOs) Program and in the private/commercial markets where payers can more readily or immediately address greening providers. The discussion concludes with Dr. Struijs commenting on provider accreditation, provider curriculum reform and lessons learned via related overseas efforts.
Dr. Jeroen Struijs, Ph.D., D., M.Sc., a 2013-14 Dutch Harkness Fellow in Health Care Policy and Practice, is a Senior Researcher at the Centre of Prevention and Health Services Research, National Institute of Public Health and the Environment, where he has been conducting research since 2000. He is also Associate Professor at Leiden University's Medical Center. Prior to his work in health policy, Dr. Struijs was a practicing physiotherapist. Dr. Struijs’ research covers a broad range of topics surrounding payment reform and innovations in the organization of health care systems, particularly in primary care. Dr. Struijs has published peer-reviewed articles in journals such as Health Affairs, Health Policy, and New England Journal of Medicine. He is member of the editorial board of the International Journal of Integrated Care, and board member of the International Foundation for Integrated Care. Dr. Struijs holds a Ph.D. degree in health services research from University of Amsterdam, and two master’s degrees: one in health sciences from Maastricht University; and, one in health services research from Erasmus University Rotterdam.
Dr. Jeroen Struijs Discusses Designing Alternative Payment Insurance Models to Green the Healthcare Industry (November 1st)