Health care costs more in the United States than anywhere in the world. That would be understandable if it led to longer lives for Americans or better health outcomes, or both. But it hasn’t.
Louisiana’s health care costs are some of the highest in the nation. The Dartmouth Health Atlas, which publishes reports on Medicare costs and quality, reveals that “higher spending is not correlated with improved outcomes,” meaning that just because you pay more doesn’t mean you’re getting better care. And in Louisiana, we spend more per Medicare beneficiary than any other state.
As for what the numbers say about what we are getting for our money, the story is not great. Louisiana ranked 48 in the 2013 America’s Health Rankings, and only 21 of 82 hospitals in 2012 met the established quality measures outlined in the Joint Commission’s annual Quality and Safety report. Further, statistics from Medicaid rank Louisiana third nationwide in emergency room use and show we have more unnecessary hospitalizations than most states.
The data are clear: We are spending more, but getting less.
So what’s the cure? I believe data could be just the medicine we need to improve quality, add value and stabilize costs in our health care system. Today, there is an abundance of data to define health care value objectively: high-quality care at a reasonable cost.
In my work at the state’s largest commercial health insurer, I oversee staff physicians and health care analysts who use tools to analyze cost and quality data. We share these tools and data with providers, using them as a guide to pay and reward doctors and hospitals for quality — which, in the end, means we’re working together to boost patient outcomes.
We are also creating quality programs that encourage providers to use data to identify areas for improvement in their practices or patient populations, and we help them make necessary changes. With a shared focus on data and quality, we expect to see our mutual customers — their patients, our members — get healthier. With these improvements, we could see health care costs stabilize, too.
But it will take a partnership among patients, providers and health insurers to make lasting advances, because we need to make sure we don’t apply a Band-Aid to our crippled health care system, when what might be required is major surgery.
Blue Cross plans to hold a summit in mid-November with health care stakeholders in Louisiana invited to address costs, quality improvements and health outcomes. The agenda — healing the health care system — will be a lofty one. But we’ll have data, quality programs and the healing hands of the medical community to make it happen.
Dr. David Carmouche
chief medical officer, Blue Cross and Blue Shield of Louisiana