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Insider’s Viewpoint: Former Obama advisor will speak to hospitalists about health reform

Robert Kocher, MD, is not a household name for hospitalists who aren’t policy wonks. That’s not to say he shouldn’t be.

Dr. Kocher, a former special assistant to President Obama on healthcare and economic policy who is now the director of the McKinsey Center for U.S. Health System Reform in Washington, D.C., was a behind-the-scenes player in the landmark healthcare reform legislation signed into law last year. After a two-year stint in the White House, he transitioned back to the private sector late in 2010, landing at McKinsey & Co., a powerhouse consulting firm in the nation’s capital.

On May 11, Dr. Kocher will give HM11’s first keynote speech, “Coming to Your Hospital: Healthcare Reform. What Does This Mean for Hospitalists.” His talk will be an inside look at how the reform package came together and point out how hospitalists can be “the solution that hospitals will want to deploy to allow them to capitalize” on reform.

“Instead of hospitalists being a de facto link [between different departments of a given hospital], I think hospitalists will be a value-creating link,” Dr. Kocher says. “There’s going to be much more information that’s going to have to flow between the inpatient side and the outpatient side if you’re going to manage population health and lower per capita costs. … It’s going to require more specialization, which hospitalists are in the right position to really take on and to deliver.”

Dr. Kocher (pronounced “coacher”) joined the reform fight in January 2009, taking a post at the National Economic Council as special assistant to the president for healthcare. He left that job last fall and rejoined McKinsey, the firm he had been with for seven years before joining the Obama administration. His career began with a medical degree from George Washington University and internal-medicine residency at Beth Israel Deaconess Medical Center in Boston.

I think hospitalists will be a value-creating link. There’s going to be much more information that’s going to have to flow between the inpatient side and the outpatient side if you’re going to manage population health and lower per capita costs. … It’s going to require more specialization, which hospitalists are in the right position to really take on and to deliver.—Robert Kocher, MD, director, McKinsey Center for U.S. Health System Reform, Washington, D.C.

He followed that with a stint as a clinical fellow and instructor at Harvard Medical School. In addition to his role as a principal at McKinsey, Dr. Kocher is a nonresident senior fellow at the Brookings Institution Engleberg Center for Health Reform.

He is a well-known speaker on healthcare topics and a frequent writer who has authored pieces for major outlets, including the New England Journal of Medicine, the Washington Post and The New York Times. The White House last year filmed him as part of its “Reality Check” Web series (www.whitehouse.gov/realitycheck/31), which is aimed at “debunking the myths” swirling around reform.

Dr. Kocher says all of his career stops pale in comparison to being part of once-in-a-generation talks that shaped the future of U.S. healthcare.

“Certainly, [it was] the most impactful thing I’ll ever get to actually do, because we were able to shape the lasting policies that will change the way healthcare is delivered for years to come,” he says. “It was an incredible privilege to get to observe and take part in that policy-making process and understand that some compromises have to happen to make successful legislation.”

Brendon Shank, SHM’s assistant vice president of communications, says that having a White House participant in the reform negotiations as a featured speaker is a treat for hospitalists.

“This is exciting because it’s someone who helped define policy,” Shank says. “This is someone who knows the inside of it. He’s been in the room for discussions that will affect hospitalists for years down the road.”

Exactly what those effects will be will take time to understand. But Dr. Kocher sees reform as a chance for HM to make itself indispensable to hospitals looking to improve quality, efficiency, and transitional-care outcomes.

Dr. Kocher is optimistic that the political squabbling the reform process has sparked will have little lasting impact.

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The responsibility will, of course, come with the challenge of actually proving that HM can deliver on the pledge of better care at better prices.

“For hospitals, as the payment system evolves and matures, we’re going to be paying more often for outcomes,” Dr. Kocher says. “That change is going to require hospitalists to become much more reliable.

“It’s a more specialized skill that doctors who are part-time hospital doctors are going to have a hard time developing. It clearly makes the system more dependent on hospitalists. … That said, I think that it’s the responsibility of hospitalists to prove they can deliver.”

Dr. Kocher is optimistic that the political squabbling the reform process has sparked will have little lasting impact. He understands HM leaders might be nervous about the potential for political upheaval to translate into medical upheaval, but he doubts that will happen.

“The political rhetoric and scuffling going on in Washington has almost no bearing on the fundamental underlying trend which will drive the market to near-universal use of hospitalists,” he says. “Whether you’re a Republican or Democrat, you share the perspective that the current health system is wildly too expensive.” HM11

Richard Quinn is a freelance writer based in New Jersey.

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