Podcast Center
Video Center
Webcasts
Resource Center
Events
April 15, 2007 at 04:00 PM
When President Bush issued an executive order in August calling for health care providers to do a better job of reporting on cost and quality, he signaled an increasing nationwide concern for finding additional ways to reduce the rising cost of health care.
With new quality reporting tools, brokers have a great opportunity to demonstrate their value by helping clients achieve cost savings.
The growing prevalence of consumer-directed health plans gives consumers the responsibility to become more active participants in health care spending. But without more information about the cost factors associated with various aspects of health care, it’s difficult to do so.
Those of us who encourage consumer responsibility have a responsibility of our own. Doctors, hospitals, health plans, and brokers must work together to find ways of increasing transparency within the health care system.
To accommodate this new movement toward greater transparency, leaders from all parts of the health care system are developing new initiatives that focus on addressing issues of cost and quality. In California, for example, health plans and providers are engaged in efforts to improve quality and efficiency, measure deficiencies and improvements and provide incentives to encourage participation. Many of the programs are designed to provide data that can change behavior and influence consumers to pursue professional services that demonstrate high quality as well as low cost-and are delivered in the correct setting only when necessary.
Providers, health plans, and purchasers can use this data to lay a foundation for new strategies that promote cost and quality improvement.
–Providers are expected to employ similar cost and quality data when adopting and utilizing appropriate practice patterns. By doing so, they can earn rewards that are funded by health plans and endorsed by employer groups for implementing improvements in their practices.
–Health plans are being encouraged to strengthen programs that address utilization management, disease management and prevention, medical policy, and contracting strategies.
–Purchasers are leveraging their purchasing power to drive change through demand for new products and standards designed to lower costs and improve quality care.
Several initiatives have already shown promise.
Pay For Performance, or P4P, the nation’s largest provider incentive program, measures patient satisfaction, prevention, and chronic care management, together with measures that reward a physician group for investing in health care technology improvements.
The program uses a common set of performance measures for physician groups, developed collaboratively by health plan and physician group medical directors, researchers, and other industry experts. It is focused on improving care for common chronic conditions, such as asthma and diabetes, access to care, overall patient satisfaction and health care technology.
Patient satisfaction includes four areas: communication with the doctor, specialty care, timely care and service, and an overall rating of care.
