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Health Policy Program

What Works

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The U.S. health care system can deliver higher quality care at lower costs. We have to look no further than our own backyards to prove it is possible. Across the nation, dozens of high performing health systems show us that high quality, affordable care for everyone can be a reality.

This page showcases some of these programs, both big initiatives and small success stories. Check back often for the latest analysis and news from our blog, the New Health Dialogue Blog.

In the News

'Frequent Fliers' Add Billions to Hospital Bills
By Joanne Kenen, Kaiser Health News, June 30, 2009
Doctors call them frequent fliers. They are the patients who leave the hospital, only to boomerang back days or weeks later. They have become a front-burner challenge not only for hospitals and doctors but also for those trying to rein in rising costs. Typically elderly and suffering from the chronic diseases that account for 75 percent of health-care spending, their experiences of being readmitted time and again reflect many of the deficiencies in a fragmented, poorly coordinated health system geared toward acute care.

Making Practices Perfect
Time-Pressed Doctors Reinvent Their Offices To Build Improved Ties With Patients
By Joanne Kenen, The Washington Post, August 26, 2008
After several years in a traditional suburban group practice that blended pediatrics and family medicine, Ramona Seidel quit to start her own micro-practice in Annapolis: a low-overhead, high-tech office that gives her more control over how she treats patients and more time to spend with them.
Patient-centered care, chronic disease management, self-care and medical homes are all buzzwords in health policy circles these days, in the midst of the national dialogue about quality and systemic reform. But countless doctors, generalists and specialists alike, are moving ahead on their own, reinventing their clinical practices and finding more-effective and more-fulfilling ways of practicing medicine.

Policy Papers & Case Studies

Grand Junction, Colorado. It is possible to delivery higher quality care at lower costs in the U.S. health care system. We have to look no further than Grand Junction, CO to prove it is possible. In 2006, average Medicare spending per enrollee in Grand Junction was $5,800, about 30 percent lower than the national average of $8,300 and more than 60 percent lower than high-cost areas like McAllen, Texas. Despite its lack of a formal integrated delivery system, Grand Junction patients benefit from excellent outcomes, state-of-the-art health information technology, and the latest innovations in preventive and palliative care at much lower costs than elsewhere in the U.S.

Realigning U.S. Health Care Incentives to Better Serve Patients and Taxpayers. This policy paper contains the recommendations from the Health CEOs for Health Reform, a diverse group of health industry leaders dedicated to creating an affordable, sustainable health system. The paper emphasizes the need to refocus health care delivery on the patient and move away from fee-for-service medicine. With proper investments in electronic infrastructure, best practice information, and payment incentives, the U.S. health care system can deliver high-quality, efficient, patient-centered care to all within the next decade.

Hill Physicians Medical Group. Hill demonstrates how an affiliated group of independent physicians can improve clinical outcomes, increase efficiency, and engender physician support for quality improvement and cost reduction activities. Working with health educators, member physicians have improved patient care, especially in the area of chronic disease management. Physicians are informed about and encouraged to participate in quality improvement initiatives, including health information technology training.

Baylor Health Care System. Baylor Health Care System (BHCS) is a nonprofit integrated delivery system based in the Dallas/Fort Worth, Texas. Baylor comprises a network of hospitals, primary care and specialty care centers, rehabilitation clinics, senior health centers, and affiliated ambulatory surgery centers. Baylor uses training programs, as well as physicians, to encourage system-wide initiatives and cement the quality mission across the system. The system has successfully implemented electronic health records, decreased mortality rates, and standardized care.

For more, check out the "Good News" section on our blog, the New Health Dialogue.





Reform Spotlight

QUALITY: Perfecting Patient Care in Pittsburgh -- The Bug Stops Here: Part I
December 1, 2009
Pittsburgh Regional Health Initiative developed a program, Perfecting Patient Care, to encourage, support and guide providers and clinicians in improving the quality of their care delivery. The program is founded on the principles of the Toyota Production System (and yes, we're talking about the car manufacturer).

QUALITY: Lessons from the Cockpit
January 12, 2010
As reported by American Medical News, participants in a six-hour training course that covered errors in aviation, related them to medical errors, and discussed how crew resource management training can prevent such errors were more likely to score highly on “empowerment” metrics.

MedPAC: Accountable Care Organizations
June 24, 2009
What exactly is an ACO? Well, there is no exact answer. But they must include three components: primary care physicians, specialists, and at least one hospital. These three groups would share responsibility for the quality of care and the cost of care received by the ACO's patients. We already see functioning ACOs taking a number of different forms, proving that all health systems do not have to move towards a one-size-fits-all model.

QUALITY: All For One, One For All -- Tackling Diabetic Care in Minnesota
February 5, 2010
Dr. Bruce Siegel of the Robert Wood Johnson Foundation highlights a "local laboratory" of health care reform in The Users' Guide to the Health Reform Galaxy. He explains how a “three pronged attack” to improve diabetic care in Minnesota produced hard, measurable results.

For more, check out our posts on "Quality" at the New Health Dialogue.