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ACOs Without the Rules: Private Sector Offers Route to Reform

Margaret Dick Tocknell, for HealthLeaders Media, November 16, 2011

Among the findings:

  • Patients believe they receive needed preventive care only 33% of the time, while physicians say it's around 50% of the time. Providing preventive care services is key to reducing the incidence of more serious illnesses as well as reducing the cost of medical care.
  • Almost two-thirds of physicians and hospital executives say that there are "significant differences in the quality of care provided by doctors" in their local area. Patients reported that they were unaware of quality differences. Reducing variations in the quality of care requires greater transparency and reporting so patients have the information they need to make informed healthcare decisions.
  • Patients responded that healthcare costs in their community could be cut by 25% to 29% without having a negative impact on quality of care. Physicians and hospital executives thought cuts of about 15% were more feasible.
  • Only 16% of patients, 16% of hospital executives, and 9% of physicians think the healthcare delivered in their community is well coordinated.
  • Looking to the future, 26% of physicians, 38% of patients, and 50% of hospitals believe that their local health community is on course to becoming more sustainable.

Simon says the survey results point to gaps in important healthcare components such as patient engagement. "We have to ask ourselves what groups have successfully put into place programs that bridge these gaps and are they scalable to other areas. Part of the work of the institute will be to identify and assess those programs."

The Optum Institute is looking at CMS and HHS programs to see where it can add value, she says. "There are a lot of experiments out there. I think we can add value as a neutral party that looks at these different programs, sees what works, and then provides opportunities for the programs to be adopted elsewhere."

The Optum Institute is one of several privately funded programs tackling the pressing problems of healthcare reform. We all know government can't do everything. It's good to see the private sector step up to help the goal of better health, better care, and lower cost become a reality.


Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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