Evidence remains strong that the U.S. healthcare ‘system’ is not efficient. In fact, according to the Institute of Medicine, about one-third of the $2.6 trillion spent on healthcare in the U.S. in 2010 was identified as being wasteful and inefficient.
In healthcare, cost and quality do not correlate with one another. Some lower-cost physicians (and hospitals) can produce high-quality care, while some high-cost health providers produce low-quality care. As stated in our ‘Voices for Value’ white paper, rewarding and making transparent cost, quality and safety measures will lead to improved efficiency without adversely affecting quality.
Indicator #8: Efficiency
When assessing the efficiencies of hospitals within their communities, Iowa employers give statewide hospitals an un-weighted score of 6.5, or a grade of ‘C.’ When segmented into five regions using size-weighted scores, four regions received ‘D’ grades, while the northwest region received a ‘mid-C’ grade.
Indicator #9: Coordination of Care among Providers
If there is one performance indicator that can be very frustrating to patients, care coordination among providers might be the one most widely criticized.
According to the Agency for Healthcare Research and Quality (AHRQ):
“Care coordination involves deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient’s care to achieve safer and more effective care. This means that the patient’s needs and preferences are known ahead of time and communicated at the right time to the right people, and that this information is used to provide safe, appropriate, and effective care to the patient.”
Within the five Iowa regions, employers view ‘coordination of care’ efforts similar to ‘efficiency’ standards – in other words, no ringing endorsements from employers. Employers give statewide hospitals an un-weighted score of 6.4, or a grade of ‘C.’ When segmented into five regions using size-weighted scores, the northwest region scored a ‘mid-C’ while the other regions received ‘Ds.’
Interestingly, hospitals in Polk County received a failing grade (‘F’) when graded by 144 Iowa employers within that county. Needless to say, key hospitals in Polk County have plenty of room for improvement in this category.
When Iowa employers experience annual premium increases that exceed the overall inflation rate, it is reasonable to expect health outcomes delivered to be at least commensurate with the inflated premiums they pay. Achieving high value for patients must become the overarching goal of our healthcare delivery system, with value simply being defined as “the health outcomes achieved per dollar spent.”
Without question, Iowa employers do not believe they are receiving top value healthcare for what they are expected to pay.
Next week, we will review how Iowa employers graded hospitals on ‘Transparency in Medical Outcomes’ – performance indicator #10 in our “Voices on Hospital” series.
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