R.I. Business group on health meets to devise possible industry reforms set by employers
Would you pay a contractor 60 percent more to get the same results as his competitor? Would you pay for duplicate work just because your vendors couldn’t communicate electronically? How about paying someone to correct his own mistakes?
In any other field, U.S. Rep. Patrick J. Kennedy told a group of business leaders last week, such things would be unthinkable. But in health care, they’re the norm. Providers are paid not for the outcome of their work, but for each procedure. Inefficiency is rampant.
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And at the end of the day, employers are the ones who pay.
It’s time to put an end to this, Kennedy told the Rhode Island Business Group on Health on Monday. As the buyers of health care, employers have the power to change the system by demanding a new focus on quality, efficiency, results.
It’s time, Kennedy said, to demand a better value for our health care dollars.
The group, which came together this spring after new Health Insurance Commissioner Christopher F. Koller urged business leaders to get involved in system reforms, set up a meeting with Kennedy as part of an effort to understand health care trends and set priorities for the group’s activism in the coming months.
Kennedy, for his part, is trying to build national support for the 21st Century Health Information Act, a bipartisan bill he co-sponsored in the House – and Senate Majority Leader Bill Frist and Sen. Hillary Clinton introduced in their chamber – to promote the adoption of information technology in health care, including electronic health records.
As Kennedy sees it, health care IT is the key to revamping the system. Computerized doctors’ orders and prescriptions can reduce medical errors, which kill as many as 98,000 people each year, he said. If providers have access to a patient’s electronic health record, they can quickly know everything they need to provide adequate care, and avoid duplicative tests. And by collecting data from electronic records, large-scale “outcomes” research can be conducted, to determine which treatments work best for each ailment, and set cost benchmarks.
The health care IT revolution is taking hold across the nation, Kennedy said, and Rhode Island is at the forefront, especially through the efforts of the Rhode Island Quality Institute, a collaboration of state leaders, educators, health care providers and insurers.
The results of this work are “going to affect you in a big, big way,” Kennedy said, so business leaders need to get involved now, and make sure their views are heard. That’s far more useful than, say, businesses’ efforts to broaden access to association health plans, he argued: “That’s just rearranging the deck chairs on the Titanic.”
Laura L. Adams, president and CEO of the Quality Institute, told the business group about three major initiatives with implications for local employers:
*A $5-million, federally funded project to develop a statewide, interconnected information exchange system for Rhode Island’s health care providers, allowing them to access clinical information about patients on a secure shared network.
*A new buy-in cooperative – still in the works – to allow doctors to adopt electronic health records with the best available technology, which they couldn’t afford on their own.
*A broader effort to restructure the health care payment system to get rid of “perverse incentives” that encourage inefficiency and pay providers to correct their own errors. “There’s no other industry where you screw up,” she said, “and bill to fix it.”
Rhode Island is widely viewed as an “IT hot spot,” Adams said, and the Lifespan hospital network, for example, has invested millions in technology that puts it well ahead of its peers.
At the health plan level, innovation is also starting to take hold, she said: Blue Cross & Blue Shield of Rhode Island is preparing to launch a “Quality Counts” program that will reward doctors for investing in IT, and in the future will reward them for good outcomes.
Such incentives are critical, Adams said, because IT and efficiency are not inherently profitable for doctors – in fact, every such move can be “one more step toward insolvency.” But Blue Cross’ effort isn’t enough, she said, and UnitedHealthcare doesn’t seem to show an interest.
Christopher R. Coté, a vice president at Marsh Inc., which is coordinating the business group’s work, urged those in attendance to use their clout to get the insurers to do more, and to get providers to embrace IT and quality improvements.
“They will listen to a payer,” Coté said.
