Consultant Touts Market-Based Health Care; Five Questions; She Says Patients Should Be at the Center of Decision-Making

Article excerpt

Rita Numerof is a Creve Coeur-based strategic consultant who advises companies involved in industries undergoing transformation.

One of those industries is health care, which has been rocked by a new regulatory environment, a new competitive landscape, new technology, and new market expectations. In her consulting work, Numerof has pressed health executives to consider the patient's well- being at the center of policy decisions.

Numerof and Michael Abrams her husband and business partner have co-authored a new book, titled: "Healthcare at a Turning Point: A Roadmap for Change" (CRC Press).

In the book, they advocate for solutions that further the creation of a "market-based" system in which consumers have a stronger hand because of greater transparency about pricing and quality of care.

"If I'm going to buy something, I want to know what I'm buying, why I should buy ' x' versus ' y' and the cost," Numerof said. "I want to know about the quality of it and how it might compare to other things I might buy."

A Philadelphia native, Numerof earned a doctorate in organizational behavior at Bryn Mawr College. In 1981, she and her husband co-founded a consulting firm, Numerof & Associates Inc.

"I grew up in the health care industry," Numerof said, explaining that her father was an executive at E. R. Squibb and Sons. "We'd have executives over, and strategy sessions occurred literally at the dinner table. So science is in my blood."

Through the decades, Numerof & Associates has grown in size to employ about 25 consultants, including former health executives and others with engineering, legal and accounting degrees. The firm has advised clients from New York to California as well as in Europe, India, China, Australia and Latin America.

Some hospitals have turned to the consulting firm with concerns about their long-term viability. Others have asked for help in solving smaller problems such as devising a new bundled pricing mechanism for cancer.

"I take a problem and look at the implications," she said. "I've always taken a systemic approach ... I am extraordinarily curious."

In her new book, Numerof warns that heavy-handed regulation may stifle innovation and the development of new medical devices and pharmaceuticals. Still, she's optimistic about the future of U.S. health care.

"More and more people have come to recognize that we have a problem (in the health care industry) and it needs to be addressed," she said.

In a recent interview, Numerof spoke about market forces and the role of government in health care. Here is an edited transcript:

- What would be the proper role of federal and state government in a market-based health care system?

In any kind of a system there needs to be appropriate checks and balances. A free market is only free to the extent that players know that they won't be able to take advantage of each other and true competition is going to enable us to get to that goal. But there have to be a certain number of regulations that are reasonable, fair, clear and appropriate that are enforced to keep that system in place. So there are specific areas for policy to play a role at the state and federal level.

- Aren't we already moving toward a market-based system with greater transparency of cost and quality of care information for consumers?

We are recently along that path, but we are not doing it at the rate and with the specificity that I think needs to be in place. We still are not sufficiently focused on the patient. The consumer still doesn't understand what it is he or she is buying, isn't clear how they are paying for it, and they are not in position yet to evaluate what the relative outcomes are. …