Cost of Care 

Cost pressures: Doctors lose authority as care standards sought

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USA Today
Summary: 

Insurers, hospitals and government agencies say it's possible to cut health costs and improve patient care at the same time.  They're using sophisticated data to identify doctors and other health providers who are using outmoded or unnecessary procedures, and pressuring them to come into line.  In some cases it's choosing a non-invasive procedure over an older, invasive type.  In other cases it's using new research data to discard a practice that's been found to be ineffective.  But doctors are concerned that they're losing the ability to respond effectively to individual cases.  The president of the Amerian Medical Association, Peter Carmel notes that, "if there are two treatments ou there in play for a given condition, most commercial interests will choose the cheaper."

Results
Doctors pressured to standardize patient care
Emily Bazar, CHCF Center for Health Reporting | November 21, 2011
Efforts to rein in health care costs are putting pressure on doctors to abandon outmoded or unnecessary practices and choose less expensive treatments, actions cost-control advocates say also can improve care. Health care systems, insurers and government agencies are using sophisticated data to identify doctors and hospitals operating outside medical norms. The goal: to wean doctors off procedures that don't necessarily benefit patients.
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Results
Health systems find the nexus between improved patient care and lower costs
Emily Bazar, CHCF Center for Health Reporting | November 21, 2011
At five Bon Secours Health System hospitals on the East Coast, giving fewer blood transfusions during heart surgeries has had some counterintuitive results: Not only did costs fall, but care improved, officials say. "People think transfusions are good, but … the higher rate of transfusions that people get, that's associated with a longer hospital stay and a higher death rate," chief medical officer Marlon Priest says.
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Results
BLOG: How one health system persuaded its doctors to change. Hint: It wasn't easy.
Emily Bazar, CHCF Center for Health Reporting | November 28, 2011
The Banner Health system, which stretches from Alaska to Arizona, delivers about 30,000 babies a year, about a third by cesarean section. When Banner officials scoured their data, they found wildly different patterns in how those C-sections were performed. That was the easy part. Getting doctors to change their behavior proved more challenging.  “We realized just asking them was not going to cut it,” said Ken Welch, chief medical officer of Banner Estrella Medical Center in Phoenix.
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Results
BLOG: Health system teaches others how to rein in overuse of medical procedures
Emily Bazar, CHCF Center for Health Reporting | November 29, 2011
Officials at Intermountain Healthcare are well aware of the growing move to standardize medical treatments and rein in differences in how doctors and hospitals practice medicine. They’re the ones teaching other hospitals and health systems how to do it. Intermountain, which operates 23 hospitals and 155 clinics in Utah and southern Idaho, has been a trailblazer in identifying and addressing excessive use of certain outdated or unnecessary procedures.
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