Dr. Marc Berg, KPMG in the US 

Marc’s pioneering work on commissioning, purchasing and operations has produced dramatic advances in outcomes at lower cost.


My name is Marc Berg. I’m a physician, health scientist. I started my career in university. I was a professor of health management and policy for eight, nine years; worked on quality, on organization of healthcare on decision making, organizationally and individually. Then becoming more and more involved in actual sort of helping hospitals to move ahead. I was asked to join Plexus, which was a niche consultancy firm in the Netherlands, where we did a lot of hospital improvement work, care programming, patient safety work, but also things like creating indicators, performance measures for governments, for insurance companies. Having become the leading Dutch advisory firm in healthcare, we were subsequently acquired by KPMG, and since then, I’ve been a member of the Center of Excellence.

My core work within KPMG is part of the Center of Excellence, and my line of work there is value-based purchasing, outcome measurement and payment reform.

When I’m thinking about this theme—something to teach, something to learn—I really think about what I’ve learned in the most impressive insight that I had over the years--is the importance of financial incentives. I’ve been working in healthcare reform for a long time, working with hospitals to improve processes; working with doctors to take up best practices in everything; and every single time, you create a great result, but the result never lasts, or the result never spreads because of wrong—perverse even—financial incentives. The moment I started to realize that that was really underlying many of our issues that we are not comfortable with, with healthcare, have to do ultimately with that. The way we pay doctors, the way we fund organizations, the way we pay for activities and not for outcomes, really lies at the root of the issues that are creating headaches for us and for our clients in Western developing environments.

So what I take from there and what I teach—the kind of things I can bring to clients, whether that’s governments or payers or commissioning groups or also healthcare providers—is thinking about, you know, just how do you realign those incentives, the contracts that you make, how you purchase care, how you commission care, how you measure what you really, you know, feel the care is about—the outcomes. That’s what I can bring. That’s where my expertise lies, and that’s what I’ve been working over the last few years with clients throughout the world.

If you don’t change the underlying financial incentives, then the positive impact you want to bring through change in culture or putting in ICT or creating better care programs, won’t last, won’t spread and won’t ultimately make the impact you want.

Value-based care system design and contracting

Marc has been a pioneer for healthcare systems that produce high quality yet affordable care, with the methods he has developed now in use in over half of all Dutch hospitals. By applying business principles of operational excellence, he has helped public and private health providers improve value and reduce costs and waste.

As senior partner of health consultancy Plexus, and previously as Professor in Health Policy and Management at Erasmus University in Rotterdam, Marc has developed practical measurements and benchmarking for quality, safety and operational performance and costs across a wide range of care settings.

Among his many achievements are a multi-million Euro hospital quality improvement project, groundbreaking work on policy incentives and payment systems and studies for government, advisory bodies and insurance companies, where he has helped shape the Dutch insurance sector’s approach to procurement. He drives innovation in care procurement strategies for health insurers and led the introduction of integrated care payment for chronic care into the healthcare system for the Dutch government.

He is an acknowledged professional in the methodology and implementation of value-based measurement and contracting and health system design.

Marc has published widely on medical sociology, sociology of technology, standardization, information technology and quality management, including a handbook on Information Management in Healthcare.

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