Physician echo - universally available quality care: from Naples Florida

This is a brilliantly written opinion from Dr. Allen Weiss, published in the Naples Daily News, in Florida.  Echo! "Transparent, objective and trustworthy quality metrics will drive America’s journey to universally excellent care and good health." ~ Allen Weiss M.D. 

Allen Weiss M.D. "Quality Care"

NAPLES, Fl - Quality matters. Better health for everyone should be America’s goal. Yet presently, where one lives and where one receives health care services can make a difference in outcomes.

Everyone — patients, families, physicians, non-physician practitioners, hospitals, health care systems and payers — should have access to the same objective information about the quality of health care services in their communities.

Accessible, transparent and comparative metrics will help move the country forward in addressing the perils of variability, consequently improving quality while lowering costs. According to the Dartmouth Atlas, a more than twofold variation in Medicare spending per capita in different regions of the country doesn’t necessarily equate with better quality or improved outcomes.

Objective comparison tools, although far from perfect, provide helpful information. The Centers for Medicare & Medicaid Services (CMS) Hospital Compare tool and its star-ratings system have been available since 2005. The easy-to-use website facilitates comparisons among hospitals based on nearly five dozen well-defined metrics.

This tool has dual benefits: assisting patients in choosing health care options and accelerating performance improvement because all can share best practices to improve health care delivery. While Hospital Compare has drawn criticism over its methodology and findings, over time CMS has responded with revisions. Such tools have value, even with their limitations.

CMS’ most recent hospital star ratings are based on seven major measures (mortality, safety, readmission, patient experience, effectiveness of care, timeliness of care and imaging) and 57 subcategories. Fair, transparent, timely and relevant scores easily understandable for patients, caregivers and payers are essential as our nation’s health care system strives to improve.

Health care is America’s largest industry, consuming 17.8 percent of gross domestic product at $3.2 trillion in 2016 and growing. U.S. health care perennially spends the most per capita yet also consistently ranks toward the bottom in outcomes among the 11 most-developed nations.

Better performance equates to fewer complications, decreased waste and lower costs. These attributes contribute to a healthier America.

Hospitals and health systems living off their past reputation and perceived greatness, embellished and polished by extensive marketing, no longer represent a rational, effective or even ethical business model.

Transparent objective metrics now make some of the most venerable institutions in the nation the most vulnerable.

Shopping for some services in health care is desirable given our consumer-centric society. But when people are sick and don’t have the luxury to check a hospital’s quality scores or prices, they shouldn’t have to worry about potentially receiving better care at the hospital across town.

Even more important, today’s hospitals and health systems should no longer see their core business as a health “repair shop.” 

Instead, we must look outside the four walls of our institutions, promoting wellness and prevention by focusing more on health rather than care.

Sadly, life expectancy has decreased for the second consecutive year, a first since 1963. Health care systems are viewed by the communities they serve as stewards of public health; we should be employing resources for socio-economic problems such as inequities of care, homelessness, hunger, violence, addiction, mental health and other maladies.

All members of the health care community have an obligation to be more responsive to customers. Sharing best practices among ourselves, just as we now share statistically accurate knowledge, will help everyone achieve better performance and outcomes.

Although the process may be uncomfortable initially, in the long run, having transparency as a stimulus for improvement will benefit every stakeholder. We can decrease the percentage of GDP devoted to sickness and hospitalization as we increase wellness and prevention.

Where one receives care matters greatly today. But let’s work to change that. Transparent, objective and trustworthy quality metrics will drive America’s journey to universally excellent care and good health.