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The Double Whammy: We Still Have Unsafe, Expensive Healthcare

It doesn't take a rocket scientist to draw the conclusion that we still have unsafe, expensive healthcare in the US, and right here in Memphis, when you read the headlines of recent reports:

AHRQ: Rate of Adverse Events in Medicare Cases "Disturbing"

Case 34-2010: A 65-Year Old Woman with an Incorrect Operation on the Left Hand

Surgery on Wrong Patients, Surgical Sites Persists, Study Finds 

Top 10 Most Costly, Frequent Medical Errors

These articles not only focus on the poor quality of our care and the impact on patients, which often includes death, but make it clear that poor quality results in excessive costs -- costs that were avoidable; costs that we as purchasers should not have had to pay. This cost is not minimal, it is significant with estimates at almost $20 billion per year in the U.S.

At the same time we see excessive, avoidable costs due to poor quality and unsafe care, we learn that right here in Memphis, we as a community spend approximately $121 million annually on potentially avoidable, primary care sensitive non-urgent care in our area emergency rooms (source: Healthy Memphis Common Table using estimates from the Center for Healthcare Economics at the Unviersity of Memphis).

I have just returned from the Annual Conference of the Naitonal Business Coalition on Health in Washington, D.C. This issue of poor quality and high cost was an underlying theme, even when hearing the latest on health reform. For example:

Secretary of Health and Human Services, Kathleen Sebelius stated that the U.S. is not getting our money's worth from our healthcare spend

Richard Trumka, President of the AFL-CIO, said that it is time to stop focusing on how we share the cost of healthcare between employers and employees re: benefit design and aggresively address the underlying problem: poor quality, high cost, and waste in the health care delivery system.

But, what can we as purchasers do about this unacceptable situation? Here are actions we CAN take:

We can demand that Memphis hospitals adopt & implement The Leapfrog Group Never Events Policy. Not all of our Memphis hospitals have yet implemented this policy which includes hospitals and doctors apologizing for their errors. See Memphis hospital performance on this policy and prior blog post. MBGH is leading efforts in Memphis to implement this policy.

We can shine the light on those Memphis hospitals and physicians that are adopting the practice of "early dispute resolution" which can more quickly resolve medical error cases to both the satisfaction of patients and their families and the provider. Read an article on this approach. A workshop on early dispute resolution was held in Memphis on October 1, 2010.

We can change how we pay for care. Purchasers must push their health plans and the delivery system to align economic incentives with the outcomes we desire. Our current fee for service payment model actually financially rewards poor quality by paying twice, once for the mistake and once to fix the mistake. We pay for the waste, we pay for the avoidable emergency room visits. MBGH is representing Memphis-area purchasers in a community-wide effort through the Healthy Memphis Common Table as we grapple with how to change payment to get the system we want and deserve.

We can structure our benefit designs to motivate employees and their families to seek care at higher quality, less harmful, more efficient providers. Now this will take courage, as we have been hesitant to aggressively share this information with employees, but we must begin to do so as it is only right to share information we have on provider quality with employees. MBGH provides tools to help our members take this bold action.

So, there is much we can do and we need to step up the plate and do it! Make a 2011 New Year's Resolution to do your part in changing a broken system that too often delivers poor quality, wasteful care.

Posted by Cristie Travis at 8:18 AM

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