Health Care Reform, Part 2

One very good outcome of the President’s speech on health care last week was the focus on cutting waste out of our health care system. I just wish more of the debate over health care reform and modernization focused on what we already know will work to slow cost increases and improve the quality of care. For example, UHC recently issued two white papers, "Federal Cost Containment - How In Practice Can It Be Done?" and "Health Care Cost Containment - How Technology Can Cut Red Tape and Simplify Health Care Administration," that show how over the next 10 years we could cut hundreds of billions from health care costs starting right now, including billions in the cost of federal health care programs and billions more in administrative savings to physicians, hospitals, government, employers and even consumers.

What’s amazing is that none of these cost-cutting ideas lowers the quality of health care and most actually lead to healthier people. All are tried-and-true techniques for cutting costs, backed by rigorous research by such distinguished groups as RAND Corporation or Dartmouth University, or by our own experience managing $115 billion of health care a year for our members.

Let’s first take a look at some things the federal government can do to save hundreds of billions in government-sponsored health care program costs:
1. Give people incentives to use higher-quality health care providers. For example, assessment of the quality and efficiency of health care providers using evidence-based standards and efficiency benchmarks and giving people incentives to use higher-quality physicians can save $37 billion.
2. Use more evidence-based care management. For example, using onsite nurse practitioners at skilled nursing facilities to manage illnesses and prevent avoidable hospitalizations can save $166 billion; utilizing integrated medical management that applies clinical evidence-based care management tools can reduce admission rates and save $102 billion.
3. Give physicians incentives to provide the highest-quality care. For example, establishing a primary physician as the central ongoing coordinator of patient care, reducing unnecessary or duplicative treatments while ensuring needed preventive care can save $20 billion; sharing comparative data on the quality and effectiveness of specific treatments to encourage physicians to adopt evidence-based clinical guidelines can save $15 billion.
4. Apply evidence-based standards to reimbursement policies. For example, application of clinical evidence to determine clinically appropriate diagnostic radiology tests can save $13 billion; analysis of claims before reimbursement to detect improper coding, duplicate billing and billing for non-existent patients can save $57 billion.

More on these white papers next time!