Local employers urged to join national effort
With encouragement from Gov. Donald L. Carcieri, a half-dozen Rhode Island employers signed a “statement of support” on Jan. 12 for what U.S. Health and Human Services Secretary Michael O. Leavitt calls the four cornerstones of a “value-driven health care system”:
• Developing health information technology, including electronic health records that are not bound to a specific provider or employer, but rather can be used by patients to learn more about their own care and to share with other providers, avoiding needless duplicate tests.
• Making available information about the quality of care delivered by different providers – from individual doctors to hospitals and nursing homes.
• Promoting price “transparency,” so consumers will know, for example, how much an MRI costs, and whether it will cost them more at their local hospital or at a nearby imaging facility. This is viewed as particularly important for subscribers to high-deductible health plans.
• Promoting quality and efficiency among providers, through incentives such as pay-for-performance systems or the use of “high-performance”
provider networks.
All four concepts have gained widespread support both nationally and in Rhode Island.
The Bush administration has promoted them in a context that is more
controversial: “consumer-driven health care” – the notion that, if consumers have a personal stake in the cost of their care, they will use resources more wisely and take more responsibility for their own health, reducing costs across the entire system.
To be effective consumers, however, people need access to their health records and to information about the potential cost and quality of the services available to them – and that will require an investment by health plans, providers and possibly the public sector.
In pledging their support for the four “cornerstones,” employers vow to use their buying power to push for that investment. The first to make that pledge was the federal government itself, through an executive order signed by President Bush in August.
Since November, Leavitt has been encouraging states and individual employers to join in the pledge; more than 150 major companies have signed on so far.
As part of that effort, the New England Council, an alliance of businesses, academic and health institutions and other organizations, was asked to host events in this region. On Jan. 11, the council hosted an event in Boston. On Jan. 12, it hosted events in Hartford and in Providence – the latter co-hosted by the Greater Providence Chamber of Commerce and co-sponsored by Textron Inc. and Blue Cross & Blue Shield of Rhode Island.
The breakfast gathering, which drew an estimated 125 people, included a ceremony at which executives from Textron, Blue Cross, Amgen Inc., EDS, GTECH Corp. and UnitedHealthcare of New England signed the “cornerstones” pledge.
But first, Deputy Health and Human Services Secretary Alex M. Azar II explained why supporting those four principles is so important.
“We currently spend $1.9 trillion a year on health care in the United States – that’s 16 percent of our GDP,” Azar said. “Health care spending is growing at a rate that poses challenges to the rest of our economy … and it’s growing for reasons that are not intrinsically related to the value delivered by our health care system.”
The answer, he said, is a “value-driven” health care system, which he defined as “the highest quality at the lowest cost.”
“Our mission for health care is to give Americans the tools they need to become educated consumers,” Azar said. Within two years, he said, he expects to have “pockets” of quality and price information available, and “value-based competition” in place among providers for some procedures. Within 10 years, such competition, coupled with IT tools, will be the norm.
Someday soon, Azar predicted, consumers will be able to research health services as they do travel information on Travelocity.com.
They’ll be able to see how much each hospital charges for a hip replacement, and which has better outcomes.
Not all those in attendance embraced his vision. Some noted that to succeed, the plan would require levels of health literacy far beyond what may be possible. Others questioned the notion that “consumerism”
is the answer to the nation’s woes. When Azar invited everyone to sign the pledge, only one unscheduled signer did so: Kerrie Jones-Clark, executive director of the Rhode Island Health Center Association.
Even the New England Council wasn’t ready to sign. Kevin Conroy, its chief of staff and general counsel, said the group hadn’t yet attained the consensus of its members on the pledge’s four tenets.
None of the state’s hospitals have signed on yet, either; Edward J. Quinlan, president of the Hospital Association of Rhode Island, said that while “we support these issues in principle,” and he views this state as a leader in IT, quality reporting and transparency, the hospitals weren’t asked in advance to sign, and they needed time to review the pledge.
Nevertheless, Christopher F. Koller, the state health insurance commissioner, and Dr. David R. Gifford, the state health director, both said the pledges matter a lot.
“It’s political support; it builds up momentum,” Koller said.
“Having businesses behind this is going to be extremely powerful,”
Gifford said. “It gives this more emphasis and priority, so that as decisions are made, we can say, ‘Look, this is a priority for businesses that employ half the population, so we need to do this.’ “
Beyond Cash Donations: How New Forms of Giving Are Transforming Not-for-Profit Accounting
Evolving Funding Landscape for Not-for-Profits Not-for-profit organizations are being asked to do more with less,…
Learn More
