Containing costs key to care delivery improvement

When it comes to improving our care delivery system, focusing on quality is the key to containing costs and improving access, according to a report issued by the Partnership for Quality Care (PQC).

According to Kate Navarro-McKay, executive director, PQC, the average family insurance policy exceeds $12,000 in premiums, and national healthcare costs are at $2.3 trillion and counting.

“Yet the more we spend, the more the number of those without insurance continues to grow, reaching 46 million last year,” Navarro-McKay says. “Likewise, healthcare was one of the top issues in the recent election-in a CNN exit poll, 10% of voters named it as their top issue, and two-thirds of voters said they were worried about how they would afford healthcare.”

As Congress and President-elect Obama begin to reform the healthcare system, they will need a way to evaluate competing proposals for reform, according to Navarro-McKay. “The PQC report demonstrates that we cannot look at expanding access to care or decreasing costs in a vacuum-improving the quality of our healthcare delivery system is the real key. That is how you create sustainable long-term savings, and it is how you create a healthy, productive populace.”

To help that discussion, the report, “Quality, Cost Control, Universal Healthcare,” includes nonpartisan recommendations for reform to hardwire effectiveness through healthcare IT; change delivery systems to address healthcare disparities; and to empower patients. There are proven strategies to combat the chronic disease that accounts for seven out of 10 deaths in America and 75 cents of every healthcare dollar the U.S. spends.

Kaiser Permanente’s chronic disease treatment program raised rates of controlled hypertension from 36%, which is the national average, to 75%. “Part of that program’s success was the use of Kaiser’s electronic health record, and a surprising part of that story was the ability of organized labor and healthcare employers to work together to design and implement the nation’s largest civilian medical record at Kaiser Permanente,” Navarro-McKay tells Managed Healthcare Executive.Montefiore Medical Center’s clinical data warehouse aggregates all patient records in conjunction with a complex statistical program that enables physicians, caregivers, and researchers to quickly perform complex longitudinal studies.

“It allows physicians to track their own patients, seeing which are meeting target treatment goals and which are slipping through the cracks,” Navarro-McKay says. “More surprisingly, it also gives every caregiver the potential to become a robust clinical researcher, pushing the frontier of medicine as he or she delivers care.”

At Group Health Cooperative, its patient-friendly electronic medical record helped patients improve their own health by integrating educational materials into the patient’s own record, and enabling them to have questions answered electronically. Forty-seven percent of patients now access their records on-line, moving them from passive recipients of health information into active, engaged participants in improving their own health.

Navarro-McKay believe executives should advocate for health reform along the following principles, to ensure a quality, affordable healthcare system:

• Ensure universal healthcare coverage for all Americans.

• Improve the quality and efficiency of healthcare services by adopting clinical best practices and promoting organized systems of care.

• Establish a stable, equitable, broad-based, and predictable healthcare financing system.

• Promote affordability and address rising healthcare costs by advancing opportunities to achieve the greatest value for our healthcare dollars.

• Provide meaningful individual choice of providers and plans while promoting preventive care, protecting consumers from the costs of major illnesses, and improving the management of chronic conditions.

• Achieve greater reliability in healthcare coverage, including improved portability of coverage and continuity of care.