Cost & Efficiency

Minnesota Releases Nation’s First Total Cost of Care Data for Medical Groups

A new report has just been published by MN Community Measurement that allows consumers for the first time to compare the cost of care at medical groups across the state. Costs from more than 1.5 million patients were included in the report, which is the nation’s most comprehensive look at the total cost of care. Information is available for 115 medical groups, representing 1,052 clinics across Minnesota and in neighboring communities on MNHealthScores.org.

The average monthly cost of medical care per patient...

Crafting a Measuring Stick For Health Care Costs

Minnesota health care leaders are building on quality measurement and improvement efforts—including reductions in avoidable hospital readmissions that led to $70 million in savings—to tackle the important, but tough, task of measuring how much an individual health care episode costs. These efforts are led by MN Community Measurement, one of RWJF’s Aligning Forces for Quality communities, which has convened disparate health care stakeholders over the years to measure everything from the management of diabetes to the patient experience.

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Primary Care Use Driving Down Costs, Improving Care

The Situation: In February 2013, CMS granted a waiver enabling the state of Ohio to move up to 30,000 uninsured adults in Cuyahoga County to a new health care coverage program called CarePlus by the end of 2013. Several AF4Q partners in the Better Health Greater Cleveland Alliance enrolled 28,294 uninsured patients in CarePlus, with a goal of providing better access, better care, and better outcomes, but with costs lower than those CMS estimated as “budget neutral.”

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Caring for the Costliest Patients: Better Care, Better Settings

By now, it is well known that “super-utilizers” account for only five percent of patients but accrue more than 60 percent of health care costs. These patients make frequent trips to hospital emergency rooms or have repeated inpatient hospital stays, resulting in costly health care, but not necessarily high-quality care.

Aligning Forces for Quality...

Sharing Data to Raise the Value of Care

An Oregon health care organization has been working to improve quality and transparency throughout the state by implementing a new public reporting initiative. The Oregon Health Care Quality Corporation, one of RWJF’s Aligning Forces for Quality communities, has been analyzing and reporting claims data from insurers and Medicaid organizations in order to offer consumers, hospitals, and clinics an unbiased comparison of provider ratings.

The data collected now covers about 3.1 million of the state’s 4 million residents, and has helped clinicians identify gaps in...

Payment Reform Pioneers Deliver on Value

Health care providers are increasingly being paid based on the value of the services they provide instead of the quantity, in the hopes of both improving quality and controlling costs. Aligning Forces for Quality alliances have worked with physicians, hospitals, insurers, employers and other stakeholders to develop and implement systems to measure and publicly report performance.

Journalist Bruce Japsen examines how hospitals and health systems participating in the Wisconsin Collaborative for Healthcare Quality have embraced new payment systems that...

Improving Transparency in Health Care Costs

The Institute of Medicine estimates that up to 30 percent of the $2 trillion in annual health care spending in the U.S. is duplicative or unnecessary. This includes spending on unproven treatments, ineffective drugs, and unnecessary hospitalizations that can be a burden to both the patient and the provider. Increasing prices for treatments and overall costs also have troublingly little relationship to good health care outcomes. Improving health care and reducing unnecessary treatments requires objective measurements of quality and costs.

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Engaging and Sustaining

Employers are the largest purchasers of health care in the United States, insuring more than 55 percent of the population. Excessive, ineffective, or harmful care costs a typical employer between $1,900 and $2,250 per employee every year. The Aligning Forces for Quality (AF4Q) initiative in New Mexico, led by the New Mexico Coalition for Healthcare Quality, is bringing employers together to help lower costs and improve the quality of care in the state.

Through the AF4Q initiative, the New Mexico Coalition has engaged many of the...

Green Light on Quality Improvement

The Wisconsin Collaborative for Healthcare Quality (WCHQ) has found its strength in quality measurement and public reporting with a natural evolution that has ushered in a complementary focus on improvement. These mechanisms, hand in hand, have led to advancing its mission to increase health care value and improve the health of people in Wisconsin. Essential to these accomplishments are WCHQ members and stakeholders, including health systems, medical groups, hospitals, purchasers, and consumers.

WCHQ has spurred quality improvement...

Leveraging Wellness & Transparency to Reduce Health Care Costs

Health care leaders have long looked for ways to lower health costs while still providing excellent value. Aligning Forces for Quality alliances bring together health providers, employers, insurers and others to share data on health care quality and cost, and engage individuals in improving and managing their health. Their efforts are producing healthier communities and substantial cost savings.

Journalist Duncan Moore examines how the Washington Health Alliance fosters a culture of health focused on wellness and transparency. This is part of "Journalists on Quality," a...

Impact