“Texas Health Resources, Blue Cross Blue Shield leaders agree paying for value, not volume, of care is key - Dallas Morning News” plus 1 more |
| Posted: 12 Dec 2010 10:18 AM PST TO This entry passed through the Full-Text RSS service — if this is your content and you're reading it on someone else's site, please read our FAQ page at fivefilters.org/content-only/faq.php This posting includes an audio/video/photo media file: Download Now |
| Posted: 11 Dec 2010 11:55 PM PST 02:00 AM CST on Sunday, December 12, 2010Douglas Hawthorne Chief executive of Texas Health Resources hospital system Why were consumers seeing substantial increases in health care costs before health care legislation, and why are costs still on the rise in the new health care reform environment? General inflation in the economy has been near zero in the last year, but the rise in the cost of providing medical care has not. Costs for supplies, drugs and competitive compensation for quality nurses in this growing market are just a few of the things continuing to drive up our costs.The cost of health insurance has skyrocketed in recent years, with premium increases far outpacing the rise in the cost of care itself. That's how insurance companies have amassed billions in cash reserves. We believe that just as health care providers are finding innovative ways to decrease costs, insurance companies also have a responsibility to do their share instead of simply increasing premiums, shifting financial responsibility onto the backs of employers, putting patients at risk with big co-pays and deductibles, and boosting profits. When it comes to costs, the benefits of health reform will be realized when quality is rewarded, keeping people healthy is supported financially instead of just paying for treating the sick, and insurance companies use more of the premiums they collect for care. How are you positioning the company to meet the demands of the health care law without knowing for sure whether the new Congress, or our state's political leaders, will allocate enough funds to implement it? Texas Health Resources is doing what other quality health systems around the country are doing – pursuing twin strategies of cost reductions in the short term and investment in improved coordination of care for the long term.If we had the solution to Medicare and Medicaid underpayment, or the solution to paying for the uninsured, we would already be able to do what is needed. The fact is, those problems are out of our hands, and we have to do the best we can with the resources made available to us. The future remains murky. We do know that we must develop closer alignment among hospitals, physicians, insurance companies, government payers and other health care providers. How is the company working to reduce costs? Texas Health began a major cost-reduction initiative in 2008 across all of our hospitals, physician offices, clinics and outpatient centers to reduce the cost of providing care. Many of these efforts have been focused on discretionary spending and reducing the cost of supplies through standardization. We're also improving productivity using benchmark comparisons to other health care systems. On the hospital operations side, we benchmark our total cost per adjusted admission to other health care systems and target the 25th percentile, meaning 75 percent of other health systems will have higher costs than Texas Health. We've implemented another innovative program at some of our hospitals and hope to expand it to others as we learn from the first efforts. The program employs intensivists, physicians who focus on caring for the sickest people in the hospital. The program has been likened to "putting a quarterback in the ICU," and it has already reduced lengths of stay and improved outcomes for many patients. I keep hearing that constantly increasing costs are an unsustainable burden on consumers and employers. What can health care providers and insurers do to change that trend in the new health care environment? What efforts do you see in that direction? There are three factors to consider – rates, or what a hospital or physician charges for services; the amount of services people use (utilization); and how sick people are when they need care (acuity). Most insurance companies want everyone to focus on rates because this is how they make money.Yet there is far greater opportunity to reduce long-term costs by reducing the amount of services people use and lowering acuity by treating people early enough and effectively so that they don't get as sick and need as much care. The current system pays on a per-procedure basis, which is a perverse incentive – it rewards providing more care for sicker people. We must change the financial structure, and that requires collaboration among hospitals, physicians and insurance companies. With the facilities you currently have now, are you equipped to meet the expected population growth in North Texas? Will you need to build more hospitals in the next 10 years? The North Texas market is one of the fastest-growing urban areas in the United States. In order to continue to offer quality health care close to where people live and work, we will need to keep expanding the reach of our network of physicians and updating our facilities. We'll do that at our current sites and new sites that will be primarily in suburban locations where the population is growing.This entry passed through the Full-Text RSS service — if this is your content and you're reading it on someone else's site, please read our FAQ page at fivefilters.org/content-only/faq.php This posting includes an audio/video/photo media file: Download Now |
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