No matter how the Supreme Court rules next month on the challenges to the 2010 health care law, there will be a continued focus on making the health care system more efficient, and senators looked at some promising options Wednesday.
Witnesses at a Senate Health, Education, Labor and Pensions Committee hearing told the panel about steps their companies had taken to deliver better health care and lower costs.
Implementing an integrated electronic medical record system and being a founding member of Rhode Island’s patient centered medical home demonstration project helped Providence-based Coastal Medical, Inc. improve the quality of care it delivers to patients, said G. Alan Kurose, the company’s president and chief executive officer. Coastal’s 91 health care providers deliver primary care to 105,000 people, about 10 percent of the state’s residents.
“We reject the status quo in our industry and aspire to set a new standard for patient experience, access to care, reported clinical quality and cost efficiency,” Kurose told the panel. A contract with Blue Cross & Blue Shield of Rhode Island is an example of a collaborative relationship between a payer and a provider group that has resulted in fewer days in the hospitals for patients, lower hospital readmissions and lower costs, among other results, he said.
Coastal’s pediatric offices are open seven days a week, and on July 1, the company plans to open an adult Sunday and holiday clinic to improve patient access. Nurse care managers and pharmacists work in every Coastal office, and patients can see their medical records electronically.
Another witness, Marcia James, director of network relations and provider engagement for the insurer Humana, said an initiative with primary care providers designed to encourage quality produced a 2 percent improvement in colorectal cancer screenings and a 4 percent increase in lung function testing during the first nine months in 2011.
A partnership with Norton Healthcare System, a Louisville, Ky.-based not-for-profit system that includes hospitals, clinics and physician practices, has produced a 9.1 percent decrease in unnecessary antibiotic treatment for adults with bronchitis; a 6.1 percent improvement for diabetic testing and an 8.6 percent improvement of cholesterol management in diabetics, among other successes. A patient-centered medical home project with Queen City Physicians of Cincinnati, Ohio, has produced a 34 percent decrease in emergency room visits and a 22 percent decrease in patients with uncontrolled blood pressure, James said.
Learning from the experiences of the private sector is critical to overhauling the entire health care system, said Sen. Sheldon Whitehouse, D-R.I., who chaired the hearing.
“We have a system-wide problem on our hands, and the solution must be system-wide, too,” Whitehouse said. “We need to look for best practices across all sectors of our health care system to inform our understanding of what is working on the front lines of reform.”