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Lessons From Abroad:. International Efforts to Improve Quality, Reduce Costs and Increase Transparency. Robert S. Galvin, MD Bipartisan Congressional Health Policy Conference January 13, 2007. Lessons From Abroad. Where The U.S. Is Different Much Larger, More Heterogeneous Population - PowerPoint PPT Presentation
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Lessons From Abroad:
International Efforts to Improve Quality, Reduce Costs and Increase Transparency
Robert S. Galvin, MDBipartisan Congressional
Health Policy Conference
January 13, 2007
2 Robert S. Galvin
Bipartisan Congressional Health Policy Conference
January 13, 2007
Lessons From AbroadWhere The U.S. Is Different
• Much Larger, More Heterogeneous Population
• Health System Much Less Centralized…By Design(?)
- Federal vs. State vs. Private Sector
• No Consensus On How To Control Costs
• Very Medical Innovation-Technology “Friendly”Where The U.S. Is Most Similar
• Common Belief: Driving Value vs. Cost Containment
3 Robert S. Galvin
Bipartisan Congressional Health Policy Conference
January 13, 2007
U.S. Has Been Improving Quality…Slowly
4 Robert S. Galvin
Bipartisan Congressional Health Policy Conference
January 13, 2007
Strategic Framework Board - 2003
Professional Organizations
Care Delivery Teams
PATHWAY #2
Goals
Purpose
Results(Performance)
Improvement
Consumers
Purchasers
PatientsMotivation
PATHWAY #1
Selection + Payment
Hospital Death Rate (RAMR)
Columbia Presbyterian 3.93*
Lenox Hill 2.26
NYU Hospitals Center 1.95
Weil Cornell – NYP 0.95*
Surgeon RAMR
State Total 2.25
Smith, C 4.15
The Power Of Transparency
6 Robert S. Galvin
Bipartisan Congressional Health Policy Conference
January 13, 2007
Payment and Improvement
“Current Payment
Systems . . . Are at Best
Neutral and at Worst
Negative Towards Quality”
MedPAC 2004 (2004)Institute of Medicine (2001)
“If I keep getting better, Dr Galvin,I’m going to improve myself
right out of business”
Glen Hackbarth
“Purchasers should…Remove
Barriers that…Impede Quality
Improvement
And Build In Stronger Incentives
For Quality Enhancement”
Immutable &
Desirable
AgeingTechnology
Unhealthy LifestylesMalpracticeEnd of Life Care
Cultural
System of
Care
UninsuredAdministrative CostsHigh Prices/Specialist IncomesWaste and Quality ShortfallsLack of Accountability/Transparency
Health Costs: Lots of Opportunity, Little Focus
