Health Groups Give Obama Details on Cost-Cutting Measures

 An interesting letter to President Obama by industry trade groups proposing to reduce cost and achieve greater efficacy within the healthcare system. It is very high level and simply points out categories of spend that need to be attacked. The question remains – Can a fragmented group of doctors, hospitals, insurers and pharmacuetical associations come together to self impose cross entity discipline? The proof will be in the pudding.

Health Care Financial Management Association

 

In a letter to President Obama today, six healthcare groups outlined specific initiatives they said would fulfill the pledge they made a month ago to help “achieve your Administration’s goal of decreasing by 1.5 percentage points the annual health care spending growth rate—saving $2 trillion or more.” The six organizations—the American Hospital Association, American Medical Association, America’s Health Insurance Plans, Advanced Medical Technology Association, Pharmaceutical Research and Manufacturers of America, and Service Employees International Union—said that their proposed system-wide cost reductions, which “will require collaboration and good public policy,” have the potential to save $150 to $180 billion on utilization of care; $350 to $850 billion on chronic care; and $500 to $700 billion on administrative simplification and cost of doing business.

Each group presented its own initiatives to contribute to the overall cost savings. The American Hospital Association said it was committed to designing and implementing a national “Hospitals in Pursuit of Excellence” campaign, which would focus on hospital performance improvements that “have meaningful quality improvement and associated cost savings.” Immediate cost savings could be achieved, according to the AHA, by promulgating best practices that would reduce surgical infections and complications, central line-associated blood stream infections, ventilator-associated pneumonia, catheter-associated urinary tract infections, adverse drug events, and pressure ulcers. The AHA also listed longer-term goals that hospitals would work towards, including “improving care coordination, implementing health information technology, promoting efficiency resource utilization, preventing patient falls, improving perinatal care, and reducing supply costs.”

The AHA said it would work with “other stakeholders to achieve a more efficient, effective and coordinated health care system. The future vision of such as system includes simplified and standardized public and commercial insurance processing systems, reducing the need to practice defensive medicine and enhancing the ability of practitioners and providers to integrate clinically to improve quality of care.

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Rating Health Care Online

This article provides insight into the many different types of health care resources and websites available to consumers regarding pricing and quality.

 

Bankrate.com

If you’re like most people, you’re taking more responsibility for and picking up more of the tab for your health care. A growing number of Web sites can assist your efforts by showing how the price and quality of care offered by different providers measures up.

1. Insurer sites

Many health insurers have member sites, says Carlton Doty, vice president and research director with Forrester Research Inc. While their capabilities vary, most include educational content as well as information on average prices for different procedures. If you’re insured, you’ll want to start your research here because the information should be most relevant to your situation, Doty says.

Aetna Navigator, the member site of Aetna Inc., for instance, lets members in more than 30 states compare prices charged by different health care providers. For example, the overall cost of a colonoscopy at one surgery center ran $1,200 to $1,800. The same procedure at a nearby hospital was $2,240 to $2,800.

The figures are based on two years of claims data, from which any extreme outliers have been removed, says Wayne Gowdy, senior product manager with Aetna. The site also offers information on the number of procedures performed at a hospital or clinic over a time period, as well as quality ratings. Aetna also offers a tool that lets members compare drug prices.

2. Government Web sites

A number of states, along with the federal government, host Web sites that provide price and/or quality information. For example, Wisconsin PricePoint lets residents of America’s Dairyland search more than 100 procedures at different hospitals, urgent care centers and emergency rooms. Use of the site is free.

For each facility and procedure, the site lists the range of prices charged, as well as the number of procedures completed, and the average and median length of stay. The figures are based on data the hospitals are required to provide to the government, says Joe Kachelski, PricePoint’s vice president. While he and his staff double-check numbers that look out of whack, they don’t eliminate outliers.

Again, the price differences can be significant. Case in point: Treating an ear infection at one urgent care center runs about $111. It’s $450 at the emergency room down the street.

3. Independent Web sites

A number of companies also operate sites. Healthgrades.com, for instance, assigns quality ratings of one, three or five stars to around 5,000 hospitals across the U.S., using data the hospitals submit to the federal or state governments.

To calculate the ratings, Healthgrades’ team adjusts the information to account for differences in patient population, says vice president Sarah Loughran. For example, one hospital may serve a largely elderly population, and age usually affects patient outcomes.

Then, Loughran and her staff will look at data on survival and complication rates, among other factors. Based on this, they’ll run the numbers to determine whether a particular hospital, given its patient population, performed as expected (three stars); better than expected (five stars); or worse than expected (one star). Most information is free. The Web site also provides information on physicians and nursing homes.


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