HEALTH CARE REFORM AND QUALITY by Michael Sack

is an interesting time indeed for health care reform. The successes of reform to date have been well documented. As anticipated, we are indeed faced with some bumps in the road as we fully implement reform. How to maintain the success of coverage expansions while addressing affordability and cost is on everyone’s mind. In short, access and cost have received a great deal of attention in the reform debate. Let’s not forget about quality.

2007 was a banner year in Massachusetts in terms of changing the way we talk about quality. 2008 is shaping up to be a bigger year in that regard. Programs that promote transparency and include public reporting go a long way toward improving quality and educating the public and policy makers.

But hospitals in Massachusetts – different from other states – are not waiting for mandates.

We believe that the voluntary approach will, in the end yield faster, better results. Over the course of just the past year we have started publicly reporting on a wide range of clinical measures. From falls to bedsores we are being completely open about the care patients receive in our hospitals. Today, anyone can log onto www.patientsfirstma.org and see how their hospital — in fact how particular units — measure in any number of areas. In an effort to offer our patients a well-rounded, ‘one-stop shopping’ view of hospital care we have also incorporated the federal government’s Hospital Compare data, eliminating the need to look at multiple websites.

In November, we became just the second state in the nation to commit to not charge for serious events that take place in our hospitals. We started with a list of the nine most serious events and are in the process of expanding the list (something that only a small handful of states have taken on).

We believe that transparency and openness breed improved quality of care. When quality improves, care improves and we believe that over the long-term cost of care can be positively affected. Generally speaking, few healthcare providers in other states have taken on accountability to the same degree as hospitals in Massachusetts

Chapter 58 addresses access, cost and quality. For good reason, many are focused on the first two. Hospitals are not forgetting about the critical third side of that triangle. We can’t forget because ensuring quality of care goes to the core of our mission, our commitment. We know that all stakeholders: providers, insurers, business, state leaders and patient advocates need to be at the same table to make the access and cost aspects of reform work. We need the same parties to collaborate on the quality agenda too because all three are linked. Concentrating on two out of the three can produce unintended negative consequences.

Neither hospitals nor any other single stakeholder controls all the factors that influence access and cost. The same is true for quality.

Michael V. Sack
CEO, Hallmark Health