Real World Health Care Blog

Tag Archives: care

Taking the Digital Leap Saves Community $20+ Million in Preventable Health Care Costs

Hospitalizations dropped by almost 3,000 people over a two-year period in Cuyahoga County, Ohio, thanks to a variety of quality changes and investments in electronic health records (EHR). This tool collects and shares critical health information about individual patients and populations across health care settings.

The nearly 11 percent drop in hospitalizations for common cardiovascular conditions (diabetes, high blood pressure, heart failure and angina) was reported in the 10th Community Health Checkup by Better Health Greater Cleveland, a regional health improvement collaborative that works with health care systems, health plans and employers to foster quality health care that’s more affordable.

Why does this decline matter? Because it shows that through efficient use of EHR, primary care is getting better in this community and has implications for advancing the quality of patient-centered care across health systems.

The report demonstrates that practices leveraging EHR are finding that they can more effectively measure care and identify opportunities to enhance service as a result: “The changes are helping people change the course of their health, and they’re adding up to measurable impact on the community – in health, care and cost.”

Better Health also notes that EHR makes a huge impact for the better when it comes to health outcomes for patients: “We have documented large differences between our EHR- and paper-based systems in terms of achievement and improvement of our standards in diabetes and high blood pressure.”

Indeed, a 2011 paper published in the New England Journal of Medicine confirms this trend, finding a 35 percent higher achievement for composite care standards for diabetes patients treated by practices using EHR compared with practices using paper-based systems. EHR sites were also associated with a 10 percent greater improvement of care and a 4 percent improvement among outcomes.

“EHRs have been well shown to improve patient safety, especially through e-prescriptions and clinical decision support,” says Dr. Tim Kowalski, President, Health Action Council Quality Forum. “They also help to improve care coordination via medication reconciliation, enhancing the exchange of health information and through the use of patient registries. And, they help to reduce redundancy via awareness of previous evaluations and various test results.”

Dr. Kowalski adds: “As health care purchasers we are demanding that health care providers demonstrate quality improvement, customer experience improvement and cost-effective care when we consider which provider groups to feature to our employees and their dependents. As we move from a world of fee for service payment to population health outcome-based compensation, this will become increasingly important.”

Have you seen examples – beyond those demonstrated by Better Health – where care is improved and costs are reduced when EHR are incorporated in the system? Tell us more.

Categories: Cost-Savings

Express Scripts Provides Roadmap to Improve Health Care, Reduce Costs and Streamline Delivery of the Medicine Patients Need

You might be in a “utilization management program” and not know what that means or why it matters to your health. Offered by a variety of employers across industries, utilization management programs are designed to help patients evaluate their health care options and make decisions about the type of services they receive.

So how do these programs impact the delivery of specialty medications for cancer, HIV, inflammatory conditions, multiple sclerosis, and more?

MedAdNews.com reports that a new study from Express Scripts demonstrates how such programs can increase efficiency by ensuring that more patients who need safe, affordable and effective medications can access them.

As spending on specialty drugs continues to increase (18.4 percent in 2012, up from 17.1 percent in 2011), finding the most effective ways to improve the delivery of patient care, reduce cost and eliminate waste is more important than ever. Combining innovations from CuraScript and Accredo, Express Scripts draws upon Health Decision Science – which integrates behavioral science, clinical science, and actionable data – as a springboard to achieve just that.

Building upon this scientific, results-driven approach, Express Scripts provides care targeted to specific areas of patient need through Accredo’s Therapeutic Research Centers as part of its Specialty Benefit Services. Here, a broad array of health care providers integrate pharmacy and medical data to offer what Express Scripts describes as comprehensive patient care that strengthens coordination of services, boosts transparency, and produces solutions.

“It’s really about appropriateness and the right thing for a patient who really deserves safe and effective and affordable medication and ruling out waste. What our plans are most interested in is continuing to be able to afford to provide a benefit. This again was a great example of by doing the right thing that patients were able to save a significant amount of money and again preserve affordability,” said Glen Stettin, M.D., senior VP, clinical research and new solutions at Express Scripts.

Does your employer use a multiple cost management program for specialty drugs? If so, what type? If not, do you think your employer should? What might be some advantages or disadvantages?

Categories: Access to Care

Will Consolidation Change Health Care for the Better?

The Cleveland Clinic believes it will, especially when it produces better patient outcomes and improves care across a spectrum of services.

As part of the recent wave of hospital mergers and acquisitions designed to improve quality and lower costs, Cleveland Clinic recently entered a long-term strategic alliance with Community Health Systems (CHS), a for-profit provider that operates 135 hospitals nationwide. While the two organizations will remain independent, they will “both [remain] committed to discovering novel strategies to improve care, reduce costs, enhance access to health care services and develop new approaches to care delivery.”

In discussing the alliance, CEO and President of Cleveland Clinic, Delos M. Cosgrove, MD, notes that thriving in today’s health care environment will require new ways of doing things. He calls medicine a “team sport.”

We couldn’t agree more. All effective strategies that successfully remove obstacles to quality, affordable care should be on the table in today’s health care environment. The Cleveland Clinic’s consolidation with CHS will lower expenses and improve the quality of care by:

  • Improving patient outcomes and reducing costs by creating a framework that enables physicians to share best practices while capturing, reporting and comparing data.
  • Enhancing quality and data infrastructure by assessing CHS-affiliated hospitals and applying the expertise of the Cleveland Clinic’s Heart and Vascular Institute to related programs.
  • Sharing best practices and creating synergies that encompass telemedicine initiatives, second opinion services for physicians and patients, complex care coordination and other areas in care and cost containment.

We look forward to watching the alliance between Cleveland Clinic and Community Health Systems as they continue to reframe health care.

Have you seen examples of successful collaborations that are improving access to care and/or reducing health care costs? Share them with us.

Three Pillars of Health Care Success: Cost Savings, Prevention/Patient-Centered Care, and Access to Care

Welcome to www.RealWorldHealthCare.org, a blog dedicated to showing what’s working to  improve health care in the U.S.

Why are we talking about improving access to good medical care? Rising costs could bankrupt us, and most people need to do a better job of preventing illness. But digging deeper, you may be surprised to learn that almost 10 percent of the U.S. population (that’s 29 million Americans) can’t afford the health insurance copayments, coinsurances and deductibles required to cover out-of-pocket costs for necessary treatments of certain chronic and life-altering medical conditions. The situation is so dire that about 60 percent of the personal bankruptcies filed in the U.S. are due to medical expenses.

As we see every day in the news, patients are facing more obstacles in accessing affordable, quality care. As across-the-board cuts to health care programs are now taking effect with implementation of the sequester – along with projected layoffs to health providers across fields – available funds to cover the rising cost of care will be strained even further. Staying abreast of the latest proven solutions to the increasingly complex challenges of our health care system is more important than ever, for patients and providers alike.

We want our blog to be the go-to source for demonstrating what’s working in our health care system by focusing on three important pillars of health care success:  Cost Savings, Prevention/Patient-Centered Care, and Access to Care.

Cost Savings: No patient – adult or child – should go without health care because he or she cannot afford it. The first step to finding solutions to the increasing cost of care is enabling health care systems and health care professionals to share their practical knowledge with one another as well as the patients who often have to choose between paying their medical bills and putting food on the table. From paying for prescription drug copayments and deductibles to affording health insurance premiums, our Cost Savings posts will explore proven strategies to help patients and families reduce the financial strain associated with the rising price of care.

Prevention/Patient-Centered Care: What’s the first thing you think of when given the words “health care?” Most people think “trip to the doctor,” or “medication.” Our attention has to shift more aggressively to find ways to help people stay healthy. Seeing a dietitian could be vital for millions of Americans hoping to live healthier and longer. Annual lab work can find vitamin deficiencies. Sometimes very simple things, like removing carpeting from the home, can contribute to better cardiovascular health, resulting in increased life expectancy. It takes a village to care for a patient. Partnerships among practitioners, payers, patients and their families are crucial for ensuring that health care decisions are made in a way that respects patients’ needs and that patients have the knowledge and support they need to make reasoned decisions and participate in their own care. In our Prevention/Patient-Centered Care blog posts, we’ll focus on the many strategies available for staying healthy and recognize ways that patients are taking an active role in decision-making about treatment options.

Access to Care: We are so fortunate to live in a world where scientists are developing novel, breakthrough therapies. But those therapies can’t result in positive health outcomes if the patients who so desperately need them can’t access them. The evidence is clear: Proper medication compliance and adherence – consistently the right medication, at the right dosage, for the right patient – is essential to mitigating chronic disease. Continued and properly managed care and staying on treatment will be the focus of our Access to Care blog posts.

We’ll be sharing real-life examples of positive health outcomes in this space, and we encourage you to join in the dialogue. How would you tackle the problem of unaffordable health care? How can business and philanthropy work together to reduce the financial burden on patients? Have you or someone you know received help paying for needed therapies? Let us know in the comments section.

Categories: General