Friday, January 20, 2012

Working with legislators to buy better healthcare value

It is that time of year when we in Maryland get a bit more “tuned in” to the workings of our government.  Maryland lawmakers have convened in Annapolis for the annual legislative session, and we see and hear of the Republican presidential campaigning and debating with regularity.

Healthcare issues are certainly front and center on both state and national stages. We are now upwards of 17.4% of our gross domestic product being spent on healthcare. This is not sustainable and our elected officials, present and future, are looking for solutions.

Healthcare reform has been called out by some as something to undo. But the huge problem of the cost of our existing system, and the fact that not all Americans have health insurance, are going to be issues that will not go away even if we have a new president.

Maryland luckily is one of the more enlightened states that has embraced the notion of healthcare reform and has embraced the notion of trying to cover more of its citizens. But most legislators realize that we cannot afford to cover even the ones that presently are covered if we don’t redesign the system.  We who have elected them owe it to our state legislators to help find new ways to make our people healthier and happier with their healthcare at lower cost.

Our legislators need to find a way to buy better value. They know that they are now spending too much on things that are not bringing better health or better care. So what are we doing to create a system of higher value?

On many issues before the state legislature this year, GBMC is working alongside our colleagues at the Maryland Hospital Association.

We’re looking forward to the creation of a healthcare exchange in Maryland – that was a key component of helping residents in Massachusetts who didn’t have health insurance. People often make the mistake thinking that those without health insurance are the poorest of the poor.  That isn’t true.  The people without health insurance are often working individuals who don’t get employer-based insurance or those who are running their own small business.  The most successful part of the Massachusetts law was creating these exchanges where for example a self-employed business person who wanted to buy health insurance could compare and contrast different plans on what was being offered and what it would cost. Creating the exchange would definitely be a step in the right direction in Maryland.  Now that insurers can’t deny you for pre-existing conditions there will be a little more competition in the marketplace for individual and small group coverage.

Along with many other Maryland hospitals, this year we are advocating for funding and innovations that will help us reach the Triple Aim.

For example, we need to strengthen hospital finances and preserve Maryland’s unique “all-payer” status system made possible by a federal waiver for setting hospital rates.  GBMC is doing its part by improving operational performance, utilizing LEAN tools to reduce unnecessary variation and implementing a surgical smoothing initiative to optimize occupancy on surgical units and drive out waste.

Our efforts also include building an integrated quality and safety infrastructure, expanding data collection and reporting, and strengthening / fostering a culture of safety throughout the organization.  In addition, organization initiatives in healthcare information technology such as implementation of electronic medical records and computerized physician order entry will support the clinical, operational and financial reporting needs of the system.

Finally, moving to a patient-centered care model will bring significant change throughout the organization.  We will accomplish this goal in partnership with our family of physicians – doctors employed by the organization (Greater Baltimore Medical Associates), as well as aligned community physicians who are members of the Greater Baltimore Health Alliance and connected back to GBMC through electronic health records which facilitates information sharing to improve care.  Our medical home model will promote wellness and more effective utilization of health care services, thereby making it more cost-effective.

What ideas do you have for how we can help our legislators redesign our health care payment system to buy better value? Please share your thoughts below.

Above I mentioned improvements to our culture of safety, and I am very excited to announce that GBMC’s new incident reporting tool Quantros Safety Event Manager went live this week.  It can be found on the InfoWeb main page (top left hand box).

One of the organization’s goals for 2012 is to increase reporting of good catches and other incidents.  We’re continuing to build an awareness of “unreliable” care and look forward to this new system which will allow for increased submission of reports - either anonymously or by registering a name.  Staff will then be able to analyze these incidents and redesign systems to achieve improved outcomes.

Staff with questions or who want to learn more can read about Quantros Safety Event Manager in the Pulse newsletter or in the Quality and Patient Safety News To Use 

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