Slate Magazine analyzed the Obama administration’s forecasted $2 trillion in health care savings, then questioned which initiatives would provide true savings. The highest ranked initiatives were
encouraging coordinated care… and
…adherence to evidence-based best practices and therapies… Coordinated care suggests clinical integration and savings derived from better information—about what works and what doesn’t work—creates efficiencies.
Increased information could increase the benefits of innovation and the ability for federated groups of health plans to use the best ideas for the best results. Secure Social Media, i.e. the idea of aiding discovery within the enterprise can help. No World Borders has been advising health care firms on ways to use social media techniques to provide openness, while still providing security and privileges regarding who can access the information within the enterprise.
- Encouraging coordinated care, both in the public and private sectors, and adherence to evidence-based best practices and therapies that reduce hospitalization, manage chronic disease more efficiently and effectively, and implement proven clinical prevention strategies.
- Coordinated care seems to suggest integration of clinical care by hospitals and doctors. If bundling requires doctors and hospitals to knock heads over submitting a single bill, integration requires doctors and hospitals to knock heads over how the patient will be cared for. “You have to grow both organically side by side,” Reinhardt says. A good start, he added, would be getting the pediatrician, obstetrician, and gynecologist to develop a common plan for an individual childbirth; medical procedures don’t come much more straightforward than the delivery of babies. “Evidence-based best practices and therapies” refers to compiling national statistics about which clinical approaches work best and then putting some pressure on physicians and hospitals to follow them. It’s very difficult to know in advance what the budgetary impact of this information would be. In a recent article in the Annals of Internal Medicine, Theodore Marmor, Jonathan Oberlander, and Joseph White wrote,
Although comparative effectiveness research may provide useful information about the clinical effectiveness and costs of medical treatment options, that information is not guaranteed to lead to significant cost savings.The Congressional Budget Office calculates that between the new money spent on research and the savings derived from better information about what works and what doesn’t, the net five-year cost to the federal government would be $490 million over five years. Total health care spending—public and private—the CBO says, would be reduced by $8 billion over 10 years. The CBO doesn’t have a five-year number, so we’ll slice that one in half.