WIHI: The Social Imperative to Demonstrate That Better Care = Lower Costs

Date: February 9, 2012

Featuring:

• Donald Berwick, MD, MPP, Former Administrator, Centers for Medicare & Medicaid Services; Former President and CEO, Institute for Healthcare Improvement (IHI)

• Gerard M. Shea, Assistant to the President for External Affairs, American Federation of Labor and Congress of Industrial Organizations (AFL-CIO)

Imagine this. You’re driving or walking or maybe even bicycling by your local hospital and you notice a big sign over the entrance that you’ve never seen before. Here’s what it says: “This hospital saved 5 Million Dollars in 2011 by improving patient care and reducing unnecessary procedures. We have returned the money to local employers, local unions, and the state.”

Sound preposterous? Hopefully not, because this is the kind of bold commitment and public declaration that Don Berwick and Gerry Shea would like everyone in health care to start thinking about, seriously. It’s just that urgent, they say, and they’ll explain why.

WIHI host Madge Kaplan welcomes Berwick and Shea to the program, fresh off Dr. Berwick’s 18 months implementing change at the Centers for Medicare & Medicaid Services (CMS), and building on Gerry Shea’s extensive knowledge of quality improvement and the promise of better care and lower health care costs for working Americans.

The problem is, we’re nowhere near there yet, especially where costs are concerned, and both Berwick and Shea believe one of the reasons is that there’s still too much of a disconnect between what better use of health care services and improvement initiatives can achieve, and what health care payers (Medicare and Medicaid, employers, individuals, etc.) are able to reap in return. As Berwick puts it, “Payers aren’t seeing it yet,” and this means that anyone footing the bill, and that’s pretty much all of us, continues to be squeezed in ways that society can’t afford.

So, what can dedicated legions of health professionals, already deeply immersed in improvement work, do differently or better? Berwick started to lay this out on December 7, 2011, at IHI’s National Forum. Berwick and Shea both say that one area ripe for review is the conceptual and often actual way in which health care organizations separate their quality and “lean” strategies, when these should be one and the same. Implementing greater efficiencies has everything to do with safety and better care, the two say. Getting this right would speed things up and generate greater savings. The question then becomes, where should the money go?