QUALITY IMPROVEMENT: The Means To The End
Two independent surveys of health care providers and health care purchasers found that while both "agree that higher quality health care can be supplied at current or lower costs," they disagree on the best strategies to achieve that goal. The Journal of Commerce reports that providers focus on improved delivery and more effective technology to spur quality improvements, but employers contend that "continued price competition and tougher negotiating" can achieve the same end. The provider survey, conducted by the Healthcare Finance Management Association and Watson Wyatt, found that 45% of employers predicted that health care services could improve without increased cost, while approximately 66% of providers said the same thing. The survey found that 77% of the surveyed managed care companies believe that a "network of health care providers linked through technology and contractual relationships" is the key to future health care arrangements. The providers indicated the need for "a more comprehensive business strategy" and 20% predict that a partnership between employers and health care providers will be an important future development. Mark Hopkins, Watson Wyatt's senior health care consultant, noted that quality improvements will coincide with increased consistency among medical groups. He said, "Now, you can go to nine different doctors with the same ailment and get nine different treatments and diagnoses. There's no consistency of practice and that's just not efficient." Hopkins suggested that a more stable patient-physician relationship, more standardization among practices and the establishment of hospital protocols will alleviate the inconsistencies. In addition, he noted that most new physicians opt to join established practices rather than establish their own practice, as "[t]he medical profession is going from a cottage industry to a business."
Moving Beyond Our Era
"We have moved beyond the era of mere cost containment in health care," said HFMA President and Chief Executive Richard Clarke. He added, "[T]he market will reward those providers that can truly manage care by finding innovative ways of delivering consistent quality at a reasonable price." The Journal of Commerce reports that 54% of providers "responded that they believe cost pressures are hurting the quality of health care," and 26% said their "greatest challenge would be delivering quality care in a managed care environment." However, Watson Wyatt's Rich Ostuw, global director of the health care practice, suggested that "those who experience cost increases and quality problems" throughout the transition will be "frustrated by the gap between potential and reality" (Dauer, 8/5).