Billed as a first-of-its-kind program, six leading health systems have announced that they are collaborating with the Dartmouth Institute to share information on outcomes, quality, and healthcare costs across a range of common conditions and treatments.
"The intractable problems of quality and cost cannot be solved without getting to the fundamental issue of how we deliver healthcare in this country," said Brent James MD, chief quality officer at Intermountain Healthcare and Executive Director of the Intermountain Institute for Health Care Delivery Research, in a statement. "By collaborating to gather data and identify the most effective care models, we can address variation in treatment, cost, and outcomes to give patients the quality care they need and bend the cost curve down in a meaningful way."
The systems joining hands are the Cleveland Clinic, Dartmouth-Hitchcock, Denver Health, Geisinger Health System, Intermountain Healthcare, and Mayo Clinic. They have a combined population of 10 million patients.
For 20 years, the Dartmouth Institute has analyzed Medicare claims data and its major work, the Dartmouth Atlas, has produced statistics showing major variation in healthcare outcome and spending across the country. That work was a keystone in the healthcare reform debate leading to regulations establishing more federal funding for comparative effectiveness research.
"There is broad support from other health care systems across the country who want to participate in the work of the Collaborative," said Dr. James Weinstein, Director of The Dartmouth Institute. "It would be enormously valuable to have the broadest geographic and demographic representation in the sharing of outcomes and experience."
The health systems say they will focus initially on eight conditions and treatments, for which costs have been increasing but for which there is enormous variability in quality and outcomes nationwide. They are knee replacement surgery, diabetes, heart failure, asthma, weight loss surgery, labor and delivery, spine surgery and depression. These conditions, according to a Dartmouth statement, amount to "billions of dollars in direct medical costs each year."
For example, for total knee replacement, a procedure done 300,000 times a year nationally, the cost ranges from $16,000 to $24,000 per surgery. In a statement, the organizations said they will develop metrics to study the care of other selected conditions and determine best practices. The heart failure and diabetes projects will begin early next year.
Added Robert Nesse, CEO of the Mayo Clinic Health System and a member of Mayo Clinic's Board of Trustees: "We need to learn from each other and put systems in place that ensure that every patient gets the very best, most appropriate care every time."