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Sustainable Cost Reductions Born from a Question

Karen Minich-Pourshadi, for HealthLeaders Media, March 19, 2012

What is value and who defines it? 

 

  • "Everybody from the insurance company to the employer."
  • "The problem is, how do you identify who is the customer?"
  • "How will a culture of value change as our relationship with the health plans changes?"
  • "How will the new, narrowed health plans impact care?"
  • "How do our patients know a test is important? We tell them it is; it's us [physicians] creating that demand."
  • "Politicians [do], but resource allocation is a societal issue and shouldn't be addressed through politics."
  • "Do you think when a patient comes in with chest pains they care about the total cost of care? They just care about getting well."
  • "You have to include patients in the culture of value; patients must be in the room learning and engaging with the team."
  • "As physicians we have to be responsible for not over-testing."

How important is data?

  • "Many of us know how to measure quality, but we need to have an idea of cost. Unless we get real cost data, we can't have discussions about reducing costs through quality."
  • "The payer uses claims data to tell us the total cost of care. I think we can do it better. We need a tool that tells us: Who is doing better than us [on cost]? Who is more efficient than us? Who's the most efficient doctor and medical group? And what are we actually putting into [the formula] that gives us the total cost of care?"
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