PacifiCare Executive Receives 2003 Innovators Award

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Dr. Sam Ho earned the 2003 Annual Innovators Award by turning popular ideas about ways to improve health care into real programs.

The Innovators Award, established in 2001 by the Health Insurance Association of America, National Underwriter and Witt-Kiefer, recognizes the transforming effect of visionary leadership in the health insurance industry.

Ho, senior vice president and chief medical officer at PacifiCare Health Systems Inc., Cypress, Calif., is best known for leading the effort to develop PacifiCares QUALITY INDEX profile of Medical Groups, a comprehensive, public report card that rates the clinical and service performance of the medical groups that treat PacifiCare plan members. PacifiCare began collecting medical group quality data for its own use in 1994 and made the quality index public in 1998.

In 2001, Ho led an effort to develop an index for the quality of health care for women. This year, his team launched an index for the quality of hospital care, and a HealthCredits program that will use raffles and discounts on products such as treadmills to reward consumers for exercising, eating better and taking other steps to improve their health.

Ho hopes to introduce a quality index for the performance of individual doctors in early 2004.

At PacifiCare, “weve been driven by the belief that whats not measured isnt managed,” Ho says. “To improve quality, you have to measure it.”

Ho gives straightforward, common sense advice for other executives at large organizations who want to be innovators.

One of his principles is that innovators should understand poet William Blakes statement that “Execution is the chariot of genius.”

“Its not good enough just to have good ideas,” Ho says.

A second principle is that, when an organization is trying to weigh the interests of different constituencies, in most cases it should do what it believes to be in the best interest of the consumer.

A third principle is that innovators must recognize the importance of reaching out to others.

Ho has only a handful of people working directly on his projects at any given time, but he enlisted many other people at PacifiCare to help, and the company has organized focus groups that involved hundreds of employers, consumers, benefits brokers and benefits consultants to discuss programs such as the QUALITY INDEX profiles.

But Ho also warns against “analysis paralysis” and letting the perfect get away with killing the good.

At some point, an organization should simply launch a program and remember it can come back later to address any problems that crop up, Ho says.


Reproduced from National Underwriter Life & Health/Financial Services Edition, November 26, 2003. Copyright 2003 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.