Paul Levy’s at it again (see his blog today) — raising uncomfortable questions and challenging his own industry as well as payers to step up to the plate to be open, transparent, and accountable on real life, real time quality measures. BIDMC got it rate of central line infections in January down to z-e-r-o.
We love it.
Can I ask a question? If I can post these rates for BIDMC, why can’t people from other hospitals? Cleve, Charlie, and Jim: Why can’t the insurance companies (Blue Cross, Harvard Pilgrim, and Tufts) post them? Governor Patrick and Secretary Bigby: Why can’t the state of Massachusetts? And, where are the public health advocates on this topic? As I have shown, the data are collected regularly. I am seeking no competitive advantage here. This is an attempt to get past a culture of blame and litigation and persuade people that transparency works: Real-time public disclosure of key indicators like this (not the untimely publication of “process” metrics) can be mutually instructive and can help provide an incentive to all of us to do better.
May I ask a question? Why does the rest of the hospital community respond to Paul with stoned silence? By the way, I think Paul should seek a competitive advantage here. Nothing wrong and everything right with hospitals competing on the basis of real quality performance. Go for it. No apology necessary.
John McDonough
February 16th, 2007 at 9:25 pm
It would also be helpful if we got the regulatory changes necessary to allow hospitals to disclose the reimbursement rates they actually receive from insurers, whether case rates or per diem payments to go along with the quality and outcome metrics.
If insurers are interested in fostering competition among providers, they should make it easier for doctors to steer patients to hospitals, imaging centers, labs, etc. that strike the best balance between cost and quality. If patients want to do their own research as well, that’s fine, but doctors drive virtually all healthcare costs through hospital admissions, ordering tests, prescribing drugs, consulting with patients, referring to specialists and doing procedures themselves. They would presumably be in the best position to make effective use of price and quality information. Of course, they probably don’t want to compete on price and quality either, but maybe they should be forced to.
February 17th, 2007 at 1:11 am
“stoned silence”? Well, that *would* explain a lot.
Seriously, good for Paul for dispensing with the loser talk.
Now how about some transparency from insurers, too?