How data and quality can help heal the healthcare system

Published November 10, 2014

When physicians take the Hippocratic Oath before they begin to practice medicine, they vow to treat patients with care. It is always the physician’s intention to comfort and heal patients, and, even better, prevent disease when possible.

Despite these good intentions, patients are still getting sick, obesity is rampant and chronic disease is choking the healthcare system.

Even worse, the healthcare system is sicker than the patients. And it’s costing us all.

Healthcare costs more in the United States than anywhere in the world.  That would be understandable if it led to greater longevity or superior health outcomes, or both.  But, it hasn’t.

On November 12, Blue Cross and Blue Shield of Louisiana will join with The Atlantic and Blue Cross Blue Shield Association to convene leaders from across the healthcare industry for a Town Hall program in Louisiana as part of the “Inventing the Future of Health” series. The agenda—healing the healthcare system—will be a lofty one. We’re bringing together providers, insurers, medical professionals, hospital systems, public institutions, educators, and other prominent community members to address health barriers, costs, quality improvements and health outcomes. 

Louisiana’s healthcare 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 as outlined in the Joint Commission’s annual Quality and Safety report. Further, statistics from Medicaid rank Louisiana third nationwide in ER 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 in our healthcare system, add value and stabilize costs. Today, there is an abundance of data to objectively define healthcare value—high quality care at a reasonable cost.

In my work at the state’s largest commercial health insurer, Blue Cross and Blue Shield of Louisiana, I oversee staff physicians and healthcare analysts who use tools to analyze cost and quality data. And we are sharing these tools and data with providers, using this as a guide to pay and reward them for quality—which in the end means we’re working together to improve our patients’ health.

We are also creating quality programs that encourage providers to use data to identify areas for improvement in their practices or patient population, 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. And with these improvements, we could see healthcare 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 healthcare system, when what might be required is major surgery. On November 12, we’ll have data, quality programs and the healing hands of the medical community to begin to find ways to make it happen. We invite you to join us by watching the live stream of the event beginning at 9:45 a.m. Central Time, or by following the event on Twitter with #ATLFutureHealth.