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Health Cost Control and Quality Improvement: More complicated than it looks

Yesterday I wrote about new research showing the huge percentage of people going to hospital ERs and specialty doctors for basic primary health care visits. Moving more of these visits for sore throats to primary care doctors isn’t the only way we need to improve quality and reduce costs though and the chart below shows how complicated the next step can be.

People and organizations opposed to the new health care law often try to make political hay around rising health costs. The naysayers like to pretend there are easy answers – magic bullets – out there to reduce costs. Consider however:

When a majority of health spending in our largest health program – Medicare – is to take care of people with serious multiple health conditions, cost control isn’t so simple. First, we already don’t do a very good job of taking care of many of these folks with chronic conditions. Just ask any adult child who has to navigate the health system with an elderly parent!

Clearly there are opportunities to improve care AND reduce costs – as Gina Upchurch does at the nonprofit Senior PharmAssist in Durham where pharmacists work with older adults on multiple medications and, in consultation with prescribing physicians, get adults off of expensive, unnecessary drugs.

In the end, cost control isn’t so simple. When we are spending most of our money on patients who are the sickest and most vulnerable, we need to put patients first and not pretend there are easy answers. That’s why the new health law contains so many provisions for study of different cost control methods, primarily on how we pay for care. Finding what works and what helps rather than hurts patients has to be our highest priority. As the Senior PharmAssist program shows, we can improve care while we lower costs – we just need to do more of it.

 

 

 

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