Cutting Costs, but Improving Quality

A top priority among healthcare organizations looking to lower costs should be reducing hospital readmissions, according to a poll of healthcare quality improvement professionals.

The survey from ASQ of more than 300 members revealed that significant barriers remain for cost-cutting changes that improve the quality of care. Improvements to both measures are need desperately in the US, which is the most expensive in the world for healthcare, but recently ranked last among 11 industrialized nations for its health system.

"It seems like healthcare providers are often faced with demands and/or provided incentives that are inconsistent or even at cross-purposes with the principles of high-quality, efficient medical care," Joseph Fortuna, MD, immediate past chair of ASQ's Healthcare Division, said in a statement. "As an example, it makes no sense for primary care doctors to be paid on volume of patients seen rather than outcomes of care."

The top priorities, in addition to reducing readmissions, according to the survey’s respondents are:

• Maximizing efficiency with existing clinical resources (staff and units)

• Implementing patient care coordination programs

• Redesigning the healthcare delivery model to include alternatives to physician delivery of primary care, such as nurse practitioners

• Improving data and analytics on return on investment of medical products/technology

Respondents named Medicare and Medicaid funding challenges as the most difficult operational challenge, followed by a model of reimbursement that favors sick-care over health maintenance, the Affordable Care Act and its impact on prices, and fragmented, uncoordinated care.

"As we've learned over time, process redesign coupled with culture change can have a huge impact on raising quality and lowering cost," Fortuna said.

The top methods for cutting costs and reducing waste include:

• Increase use of quality and process engineers in healthcare settings

• Focus more on lean management principles

• Implement mandatory process improvement training for healthcare professionals

• Create financial incentives to deliver efficient care.

Respondents also offered suggestions like using integrated healthcare records to decrease errors and streamline patient care by decreasing the need to keep asking the same questions. They added that a better implementation and acceptance of preventive medicine will reduce demand, and thus costs.