New Group: Focus on Healthcare Quality

By Trish Anderton on Wednesday, April 3, 2002.

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A group of New Hampshire employers is hoping to revolutionize the state's healthcare system. The New Hampshire Healthcare Purchaser Partnership held its first meeting in Concord this morning. As NHPR's Trish Anderton reports, the Partnership says the insurance system should focus on quality, not cost.

ABOUT A HUNDRED EMPLOYERS AND STATE OFFICIALS GATHERED TO LISTEN TO MASSACHUSETTS-BASED CONSULTANT MICHAEL BAILIT DIAGNOSE WHAT?S WRONG WITH HEALTHCARE. THE MAIN PROBLEM, BAILIT SAYS, IS THAT THE SYSTEM DOESN?T REWARD GOOD CARE, SO DOCTORS AND HOSPITALS DON?T HAVE TO STRIVE FOR HIGHER QUALITY AND EFFICIENCY.

that?s what they should be competing on. Not who has the nicest lobby and who has every provider in their network. But who delivers the best value.

CRITICS OF THE CURRENT SYSTEM SAY AS A RESULT, AMERICAN PATIENTS HAVE TO PUT UP WITH HIGH COST, AND POOR HEALTH. THEY POINT TO STUDIES THAT SUGGEST MEDICAL ERRORS KILL NEARLY 100-THOUSAND PEOPLE A YEAR IN AMERICAN HOSPITALS. ALEX FELDVEBEL IS THE STATE?S DEPUTY COMMISSIONER OF INSURANCE.

there is tremendous waste in our current system, there are significant medical errors and inconsistent care. Even when we know what the best practice is // there is significant variation in treatment from one area of the country to the next.

REFORMERS SAY FOCUSING ON QUALITY WOULD BOTH LOWER COSTS AND IMPROVE CARE. BUT HOW TO DEFINE QUALITY IS STILL AN OPEN QUESTION, AND POTENTIALLY AN EXPLOSIVE ONE. CONSULTANT BAILIT ADMITS THERE?S NO PERFECT MEASUREMENT. BUT HE SAYS HEALTHCARE EXPERTS DO HAVE SOLID INFORMATION TO GO ON.

We know to a fair degree based on evidence what kind of medicine seems to get best results. We have information on what practices help avoid medical errors. We can use that to assess performance in the system.

BAILIT ENVISIONS A SYSTEM THAT WOULD CHARGE PATIENTS THE LOWEST CO-PAYMENT TO GO TO THE MOST EFFECTIVE DOCTORS OR HOSPITALS. THE RATINGS WOULD CHANGE ACCORDING TO THE SPECIALTY; SO A HOSPITAL MIGHT RANK HIGH FOR HEART SURGERY AND LOW FOR CHEMOTHERAPY. BAILIT?S IDEAS SEEMED TO BE WELL-RECEIVED BY BUSINESSPEOPLE IN THE AUDIENCE. AND EVEN A HEALTHCARE ADMINISTRATOR EXPRESSED ENTHUSIASM. NICK VALIS RUNS THE BEDFORD AMBULATORY SURGICAL CENTER.

We need to empower the patient and employer. Right now, the tables are reversed.

A SPOKESMAN FOR ANTHEM HEALTHCARE, THE STATE?S LARGEST INSURER, AGREED QUALITY IS THE NEXT FRONTIER. BUT HE SAID CHANGING THE SYSTEM WON?T BE SIMPLE. THE PRESIDENT OF THE NEW HAMPSHIRE HOSPITAL ASSOCIATION, MIKE HILL, STRUCK A MORE SKEPTICAL NOTE.

Theres many types of conditions that have lots of treatment alternatives. Nobody knows what is the ideal or best approach. And in fact in many cases it has a lot to do with who the particular patient is.

THAT SAID, HILL ADDED THE HOSPITAL ASSOCIATION IS ALWAYS INTERESTED IN NEW IDEAS TO IMPROVE CARE. THE NEW HAMPSHIRE HEALTHCARE PURCHASER PARTNERSHIP PLANS TO TAKE FEEDBACK FROM TODAY?S MEETING AND CONVENE A SECOND ORGANIZING MEETING SOON. FOR NHPR NEWS I?M.