Using high-quality providers to cope with today's rising health care costs

Article Abstract:

One way to control health care costs may be to identify hospitals that provide cost-effective health care and then encourage patients to use these hospitals. The Greater Cleveland Health Quality Choice Coalition, which consists of 31 Cleveland hospitals treating over 100,000 patients, will analyze the medical records of those patients to identify cost-effective treatments. When plant managers at ALCOA's Knoxville, TN facility began measuring patient outcomes, they limited increases in health care costs to 5% in two years, compared to increases of 14% at other ALCOA plants in the US. Intermountain Health Care, a consortium of 24 Utah hospitals, studied patient records to determine the best time to give a surgical patient antibiotics to prevent postoperative wound infections. By encouraging its surgeons to administer antibiotics within two hours of surgery, it reduced the postoperative wound infection rate to 0.4%, compared to the national average of 2% to 4%. The savings in one hospital alone amounted to $720,000 a year.

Analysis, Innovations, Medical records, Health care reform

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NCQA: quality through evaluation

Article Abstract:

The National Committee for Quality Assurance (NCAQ) is updating its database on performance measures that evaluate the quality of health care delivered by health maintenance organizations (HMOs). NCQA is the organization that accredits HMOs but fewer than 25% of all HMOs have been fully accredited. NCQA has also begun evaluating the performance of HMOs and the database used to collect information on HMO performance is called the Health Plan Employer Data and Information Set, or HEDIS. HEDIS formerly focused on preventive health measures such as vaccination and medical screening but will now include care of the sick as well.

Information services, Health maintenance organizations, National Committee for Quality Assurance

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Health plan accountability still a long-term goal

Article Abstract:

Physicians, managed care companies and government agencies are working to develop performance measures for managed care. The growth in managed care organizations has been substantial and 80,000 to 90,000 Medicare beneficiaries are moving to managed care plans every month. Twelve million Medicaid beneficiaries were enrolled in managed care plans in 1995. The Health Care Financing Administration is developing outcome measures for many diseases as well as patient surveys.

Managed care plans (Medical care)

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