Showing posts with label Intermountain. Show all posts
Showing posts with label Intermountain. Show all posts

Hospital Improves Maternity Care and Lowers Cost



Today’s Managing Health Care Costs Indicator is $3.5 billion


Maternity care really matters.  Earlier prenatal care, prenatal vitamins, and cigarette, alcohol and drug cessation help us have healthier children – and prevent excess health care costs. Still, maternity represents 20% or more of hospital admissions for many employers, and sick newborns often represent a quarter of all catastrophic care cases. 

Caesarian section delivery is shockingly common in the US – about 1/3 of all deliveries at this point.  The World Health Organization has recommended an optimal rate of 15%.  C-sections increase the likelihood of complications of subsequent deliveries –and they decrease the new mom’s ability to immediately bond with the newborn.  Once a woman has an initial c-section, it’s unlikely she’ll have a future vaginal delivery, as VBAC deliveries are increasingly rare.

Induction (intravenous drugs to start the labor process) is also quite common in the US– and can start the cascade toward C-sections – since if induction is begun before the cervix has started to dilate, it’s likely to lead to prolonged labor that is ended by Caesarian section.

The variation in elective induction is dramatic across different institutions – here’s a link to the Leapfrog Group’s website , where you can see elective induction rates by hospital. 

Health Affairs just published an article from Intermountain Health describing its focus on system variation (not merely variation of individual clinicians).   Intermountain’s efforts began over a decade ago – and cover a range of medical care.  I’ll focus here on the results of their maternity process improvement.

Intermountain recognized that 28% of their elective inductions in 2001 did not meet medical criteria –and imposed the following rule. 

When an expectant mother arrived at the hospital for an elective induction, nurses completed an electronic check sheet that summarized appropriateness criteria. If the patient met the criteria, the induction proceeded; if not, the nurses informed the attending obstetrician that they could not proceed without approval from the chair of the obstetrics department or from a perinatalogist—a specialist in high-risk pregnancies.

With the initiation of this rule, the percent of elective inductions which did not meet clinical criteria dwindled to 2%!  Intermountain’s c-section rate is 21% now – over a third lower than the national average.

The authors state that $50 million in annual medical costs have been averted through this simple program, and extrapolate that a national effort like this could save $3.5 billion per year.

This is a great example of making care better for moms and babies and saving money at the same time.  I often talk about how we have to make difficult choices to improve value in health care.  The only tradeoff necessary to lower inappropriate elective inductions, and thereby lower c-section rates and premature deliveries is a small decrease in physician autonomy.    Seems like a very good tradeoff indeed!

Brent James and Intermountain Health - Following Rules Improves Care


Tomorrow’s New York Times Magazine  has a thoughtful piece by economics reporter David Leonhart about Brent James, the Chief Quality Officer at Intermountain Health, a hospital system in Utah.  Intermountain is often cited as one of the “high value” health care delivery systems – it has lower complication rates and lower overall costs.   Intermountain, under James’ leadership, has developed detailed “best practice” algorithms for at least 50 conditions representing half of all hospitalized patients, and has gone through the difficult process of convincing doctors that they should follow the rules, rather than their “gut.”

Leonhart points out that in most industries, developing methods to lower the resource costs while maintaining or increasing quality allows growth in market share.   However, under fee for service reimbursement, a hospital like Intermountain loses money when it prevents complications – because it is no longer paid to treat those complications.  For instance, Intermountain says it lost $329,000 by standardizing protocols for inducing labor in expectant mothers (and decreasing babies with premature lungs).  Toyota doesn’t lose money by making cars that were more reliable.  If it did, we would all still be driving AMC Ramblers (a notoriously unreliable car from the 1960s)!

I also appreciate that Leonhart referenced the ongoing debate between those who emphasize the “art” of medicine, like Jerome Groopman, and those who espouse the science like Brent James.  “Cookbook medicine” is not right for every patient, and good physicians know when to deviate from evidence-based rules.  But at least half of all patients are cared for by below average physicians, and populations have better outcomes when physicians follow rules more closely.    Furthermore, the evidence-based rules generally don’t favor the most expensive approach to an individual patient’s treatment.   Comparative effectiveness research could help us enlarge the body of evidence and create more rules.  When physicians and care teams follow those rules, outcomes will be better and physicians can focus on difficult decisions where the evidence is less clear and where their wisdom and expertise will really drive more value for patients.

Much of the change that will decrease the rate of health care inflation has to come in the delivery system (where 85+% of all the dollars are spent).  Intermountain offers the promise of evidence based care that is better and saves money.  Let’s hope the health care reform that passes is able to provide incentives for more organizations to follow this approach.