WASHINGTON, D.C. - Resolving healthcare's quality conundrum will require employers, managed care plans and providers to get on the same page of measuring outcomes before the government steps in to legislate it, according to top brass at Eli Lilly, Cigna HealthCare and the Mayo Foundation.
Acknowledging that no "quick fix" solutions to the quality questions plaguing the industry exist, Eli Lilly's CEO Randall L. Tobias, Cigna's President H. Edward Hanway and Mayo's Chairman Dr. Robert Waller tackled the controversial issue of how to communicate healthcare value to consumers at the National Business Coalition on Health's Leadership Summit held here last week.
Highlighting the need for collaborative calls to action among employers, providers, managed care organizations and other key healthcare sectors, the speakers stressed launching quality initiatives that involve:
- boosting prevention/wellness services;
- developing standardized quality outcomes management systems that can be customized on the community level;
- incorporating patient satisfaction surveys throughout the continuum of care; and
- integrating the delivery of care and disease management.
Sounds Good, How Do We Execute
Coalition members who attended the conference and via satellite touched on quality issues that industry communicators also struggle with: how to implement quality initiatives on the local level and maintaining quality during mergers and acquisitions.
The panel offered a patchwork of solutions. Tobias suggested that health coalitions drum up ways to "not re-invent the wheel" by using quality standards like HEDIS outcomes that can be used nationally but customized on the local level.
And Dr. Waller focused on provider direct contracting with employers and becoming third party administrators.
And to retain quality when organizations merge, Catherine Kunkle, NBCH's acting president, highlighted the value of benchmarking and strengthening community communication that addresses how a particular merger or acquisition will improve quality. (NBCH, Nancy Guiden, 202/530-4537)
Top 10 Quality Trends
Healthcare is evolving into better patient accountability as well as communicating and proving quality of care, says Dr. Robert Waller, chairman of the Mayo Foundation. Forecasting how quality will be defined in the 21st century, he offered these David Letterman-style top 10 indicators at the National Business Coalition on Health's Leadership Summit:
10. Integrated delivery systems (IDS) will continue to dominate the marketplace.
9. Physician relationships will remain unclear. Considering the bleak fates of MedPartners and PhyCor, the role of physician groups is tenuous.
8. Managed care will continue to be a major target for reforms.
7. The battle over which providers deliver quality healthcare - not-for-profits or for-profits - will continue to waged.
6. The cost of healthcare will remain high on the industry's agenda, particularly with providers and managed care plans.
5. Quality improvement breakthroughs will continue via vehicles like clinical outcomes and report cards.
4. Consumer confidence in healthcare will continue to be poor if the industry continues to focus on profit.
3. Patients will participate in more of the healthcare decision-making process through options like open access and point-of-service plans.
2. The rapid change in healthcare will continue to cause physician unrest and anxiety. Disability claims among doctors will rise.
1. Healthcare fraud accusations will continue to have a negative impact on the quality agenda and patient confidence. Currently, 4,700 of the country's 6,000 hospitals are under fraud investigations.