Tuesday, September 16, 2008
Pursuing the Holy Grail, in real time
Let's try some real-time blogging. I just arrived at a conference organized by the Blue Cross Blue Shield Foundation, entitled In Pursuit of Health Care’s Holy Grail: The Quality Movement that is Transforming Health Care. It is being held at the JFK Library and Museum in Boston and is basically a real-life version of a recent book written by Charlie Kenney, entitled The Best Practice: How the New Quality Movement Is Transforming Medicine. Here's a Boston Globe op-ed article written by Charlie summarizing the main points of the book. It is a compendium of success stories in the quality and safety arena from around the world.
Here's a July 23, 2008 podcast of WGBH's Emily Rooney interviewing Charlie. One thing on which he and I would disagree is his relative emphasis on the need to change the payment system to accomplish quality and safety improvements in hospitals. That view is consistent with Blue Cross Blue Shield's hope to engage hospitals in their so-called alternative contract, which is a major part of their program. Their emphasis is not surprising. When you are an insurance company, your major tool for influencing behavior is pricing, and, as they say, when you have a hammer, everything looks like a nail.
It is interesting to note, though, that the whole range of quality and safety initiatives begun by BIDMC is being done under the traditional compensation system. We get no financial reward from insurers for this program, and yet we find it in our strategic and financial interest to pursue it nonetheless. The plan being proposed by BCBS puts a major insurance risk on hospitals by capitating payments, and the company has yet to address that proposed shift in risk from the insurance company to the providers -- rather than recognizing that there are multiple ways to encourage the quality and safety results they seek. But that is a topic for another day, and will either be resolved or not in the context of our contract negotiating sessions.
The speaker who gets the distance record for this conference is Göran Henriks, Jönköping County, Sweden. His picture is above. You can read about the path taken by the folks in this network of hospitals and ambulatory centers here.
Another notable speaker at the event is Sorrel King, Founder of the Josie King Foundation. Her picture is above, too.
As the day goes along, I'll post any interesting observations that come my way.
Posted by Paul Levy at 9/16/2008 08:37:00 AM