In Massachusetts, two groups have been meeting, separately for several years to address rising healthcare costs. The local NPR radio station, WBUR had an interesting story today profiling these two groups and the conclusions they reached for controlling rising costs.
The first is a coalition of academic medical centers, hospitals and payers who concluded that the focus needs to be on quality. Better quality = Better outcomes -> Lower Total Costs.
The second group is a collection of major employers in the state. There conclusion is that costs are tied to treatment options and that for some procedures, more expensive treatments do not generate statistically different outcomes. This is a hot topic in DC and among researchers who will see some $1.1B in federal spending go to “comparative effectiveness” research. The employer group in Massachusetts is now looking at various options to encourage (provide incentives) employees to choose the lower cost, but just as effective procedure. Equal, but lower cost procedure = Lower total healthcare costs.
What is interesting here is that in the first case, it is all about preserving the physician’s right to chose what is best for their patient, but just insure that whatever is chosen is done using best practices to insure quality. The second case is more of a rationing model, not always a bad thing, but it sure will crimp the style of many a practicing physician with a particiular hankering for a procedure simply because it may be what they know best, or perversly, what they can get the highest reimbursement for. It is unfortunate, however, that these two groups appear to have never met together to jointly address the issue as all are stakeholders would ultimately benefit from a meeting of the minds.
Then again, the healthcare sector is a political minefield and maybe it is best to strike-out separately in different directions moving quickly to reach consensus. Now the question is: How to take that consensus to the next level and execute on it.