Moving Forward, One Step at a Time

MANAGED CARE December 2004. ©MediMedia USA

John A. Marcille

In this holiday season, I am pleased to bring you an issue filled with good news. Or, at least, with useful information on diverse topics from compensation for providers to dealing with obesity.

• Starting at the top, we have a piece about what Brent James, MD, executive director of Intermountain Health Care's Institute for Health Care Delivery Research, is doing to stimulate development of pay-for-performance systems that share the actual savings that the systems create, rather than just paying for following a set of rules.
• Health care companies are frantically developing new products to compete in the "consumer-directed" arena. But they are largely untested, and purchasers are wary. Some health plans have discovered a way to get that testing done and save money to boot, using their own employees in pilot programs.
• The cost of coping with the health effects of being overweight might not be so large as we all fear, if our article on the topic is even close to being on target. A fair amount of evidence is being accumulated that we can help fat people be healthier than they are — even without losing weight, and maybe healthier than they would be if they did lose weight (and then, almost inevitably, regain it).
• Boards of directors are insisting on more from their CEOs, and are willing to pay for it.
• Bar codes for drugs administered in the hospital, bold marks to identify which limb to amputate, and other schemes are being trotted out to combat the scary level of medical errors that the Institute of Medicine has reported so vociferously. Medical administrators at two health plans discuss the problem and what they are doing to reduce the occurrence.

All in all, this is an issue that shows progress on many fronts in the managed care field. Happy holidays!