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Analysis

Senators Discuss Innovation as Healthcare Cost-Cutting Tactic

By Steven Porter  
   November 29, 2018

The chief medical officer for HCA Healthcare testified about the ways his company has sought to employ innovations driven by science and technology in a way that improves U.S. healthcare more broadly.

Senators listened Wednesday to testimony on how U.S. healthcare leaders can use innovation as a tactic to reduce healthcare spending.

The hearing before the Committee on Health, Education, Labor, and Pensions was the fifth this year in a series exploring a variety of cost-reduction strategies.

"We sometimes find we do as much good by putting the spotlight on issues as we do by passing laws, and this is an example of putting the spotlight," Chairman Lamar Alexander, R-Tennessee, said before reading his opening remarks.

Jonathan B. Perlin, MD, PhD, MSHA, MACP, FACMI, president of clinical services and chief medical officer for HCA Healthcare, based in Nashville, was among the healthcare leaders to testify in Wednesday's hearing. He shared three stories of how HCA had used scientific research to inform quality-improvement projects that benefited not only the company itself but other organizations as well.

Perlin said hospitals and physicians hadn't fully recognized the benefits of delivering babies at 39 weeks, instead of 38 or 37 weeks, leading obstetricians to perform medical interventions that led to earlier deliveries for decades. After HCA partnered with March of Dimes on a study that showed the risk for complications was twice as high at 38 weeks than 39 weeks and four-times greater at 37 weeks than 39 weeks, however, the organization defined a 39-week "hard stop" that punishes obstetricians who conduct elective deliveries earlier and which has since become industry standard, he said.

"This fundamental change in practice is estimated to save the Medicaid program over a billion dollars annually," he added.

In follow-up questions, Alexander asked how health systems can reap the benefits of technology-driven innovation without their electronic health record (EHR) systems becoming more of a burden than an asset.

One of the keys to correctly conduct a cost/benefit analysis around EHRs, Perlin replied, is thinking in terms of "data liquidity."

"Rather than the EHR being both the beginning and the end of health information, it's a piece of it," he said. "Once you have that health information, we can really use the tools of data science and artificial intelligence to improve healthcare, make it more efficient."

Previous Hearings in the Series
 

The Senate HELP Committee has held five hearings this year dedicated to healthcare cost-reduction tactics:

  1. Understanding the Cost of Healthcare (June 27)
     
  2. Eliminating Excess Spending and Improving Quality and Value for Patients (July 17)
     
  3. Decreasing Administrative Spending (July 31)
     
  4. Examining How Transparency Can Lower Spending and Empower Patients (September 18)
     
  5. Improving Affordability Through Innovation (November 28)
     

The full list of witnesses and video recordings of each hearing are available on the committee's website.

Steven Porter is editor at HealthLeaders.


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