MANAGED CARE April 2006. ©MediMedia USA
Qualilty — by which we really mean "high quality" — is something that we all pay lip service to. I mean, you arrange for really good care for your beneficiaries, don't you, just as I arrange for useful articles on cutting-edge topics. And so on.
From time to time, however, we have to face reality. Nobody's perfect, and that goes for the health care delivery system. I'm not even going to mention that article in the March 16 issue of the New England Journal of Medicine, the one titled "Who is at Greatest Risk for Receiving Poor-Quality Health Care? [1]" by Stephen M. Asch, MD, MPH, et al, that found that "participants received 54.9 percent of recommended care," and that pretty much went for all sociodemographic groups.
I am going to mention a survey taken by about 550 physicians, health plan leaders, employers, and government officials at recent "State of Our Health" forums sponsored by AstraZeneca, and about 350 purchasers who read Employee Benefit News.
This survey (of the understanding and attitudes) of these leaders reports that "Almost uniformly, respondents stated that they did not believe the health care system is driven by quality." Employers were more emphatic, but even three-fourths of the providers and others attending the forums felt that way.
It's important that we know this, but we must also recognize that many or most of us are truly eager to engage in programs that will improve quality. We have loads of P4P programs being tried out across the land, for example, and we have pretty common agreement that "best practices" offer a solid route toward better care, and better value as well. Also wellness and consumer programs.
Our hearts are in the right place. Now we need to perfect the systems and, oh yes, make the economics work.