As the public debate over health care reform continues to focus on the "individual mandate" and other hot-button issues, U.S. Senator Sheldon Whitehouse (D-RI) today held a hearing about another effort that has gotten less attention but is actually more important: delivery system reform (DSR). The hearing examined health care improvements already being achieved through delivery system reform efforts, and highlighted the vast potential of these reforms to lower costs and improve care without cutting benefits.
"This hearing is a chance to hear from private sector innovators who have taken this cause to heart, and are seeing results," Whitehouse said. "While increasing health care costs are the primary driver of our federal debt and deficit, they are not unique to government health plans. Costs are going up for everyone, whether they are insured by Medicare or Medicaid, the VA or TRICARE, Blue Cross or United Healthcare We need to look for best practices across all sectors of our health care system to inform our understanding of what is working on the front lines of reform."
The Senator also identified five priority areas for reform efforts: payment reform, primary and preventive care, measuring and reporting quality, administrative simplification, and health information technology.
Whitehouse chaired the hearing of the Health, Education, Labor, and Pensions (HELP) Committee, which was entitled "Identifying Opportunities for Health Care Delivery System Reform: Lessons from the Front Line." Witnesses testifying at the hearing included Dr. Al Kurose, President and CEO of Coastal Medical in Rhode Island, who discussed how DSR efforts have helped lower costs.
"We have committed ourselves to reduce the total cost of care for our populations of patients by 5% by the end of 2014," said Dr. Kurose. "Already, we can point to significant accomplishments in our efforts to reduce costs, and most of our potential in this endeavor has yet to be realized."
Kurose also noted the improvements in patient services Coastal Medical has implemented. He noted that "every phone call is now answered "Hello, Coastal Medical. Would you like to see a provider today?'" Coastal Medical recently initiated the "Coastal 365" campaign to let their patients know that an office will be open where they can see a primary care physician 365 days a year.
Other witnesses testifying in today's hearing were Marcia James, Director of Provider Engagement for Humana, Inc., and James C. Capretta, a Fellow at the Ethics and Public Policy Center.
James spoke about some of the specific DSR efforts Humana has worked on, including a pilot program with Norton Healthcare System in Kentucky that stresses accountability of measured outcomes, cost, and patient delivery. "Already, the partnership has shown significant results," she said, pointing to a 9.1 percent decrease in unnecessary antibiotic treatment for adults with bronchitis, a 6.1 percent improvement for diabetic testing, and 8.6 percent improvement for cholesterol management in diabetics.
According to President Obama's Council of Economic Advisers, we could save more than $700 billion annually in our health care system by routing out waste and inefficiencies, without hurting the quality of care.
Senator Whitehouse has been a leader in the DSR effort since his time as Rhode Island's Attorney General. He helped secure new investments in Health Information Technology in the American Recovery and Reinvestment Act -- including a provision to establish the Regional Extension Center Program -- and was also a strong advocate for the inclusion of delivery system reforms in the Affordable Care Act. Earlier this year, Whitehouse released a report on the Administration's progress in implementing the DSR provisions of the health care law.