Hospital Proves That Improved ICU Quality Saves Dollars

Sentara Williamsburg Regional Medical Center (SWRMC) has gone 5 years and hopes to celebrate its 6th year of no ventilator acquired pneumonia (VAP) cases in its ICU. This experience puts SWRMC in the top 10% of hospitals nationally in VAP experience. SWRC's ICU costs are $6,000 less that other comparable hospitals.

VAP is the second most common hospital acquired infection and the most common in ICUs.

This achievement is due to managing length of stay and ventilator days through:

• Screening protocols which result in fewer patients being put on ventilators in the first place
• Implementing the Institute for Health Improvement's ventilator bundle
• And, as The Leapfrog Group requires, using a dedicated intensivist (a physician specially trained in critical care medicine) in the ICU.

SWRMC's experience shows that better quality does indeed cost less. Employers have a vested interest in whether or not hosptials implement these types of process improvements as these improvements result in better care for the patient and cost the patient and employer less. MBGH is the Regional Roll Out leader for The Leapfrog Group here in Memphis. Employers should continue to push, through MBGH, for these types of improvements so we too can benefit here in Memphis.

Click here to read the article.

DOL Fact Sheet on New COBRA Premium Subsidy Program

The Department of Labor just released a fact sheet on how the 2010 Defense Appropriations Bill affects COBRA Premium Subsidies.

Click here to see the Fact Sheet.

COBRA Coverage & Subsidies Extended

From USA Today: "President Obama has signed legislation that will allow laid-off workers to receive subsidized COBRA premiums for up to 15 months. Previously, the subsidy expired after nine months.
The extension, included in a defense spending bill approved by Congress over the weekend, also extended the cutoff for eligibility for the COBRA subsidy to Feb. 28, 2010, from Dec. 31."

Click here to read the entire article.

Medical Center Chief Medical Officer Proud to Be a Leapfrog Top Hospital

Dr. Jonathan Gottlieb, Chief Medical Officer at University of Maryland Medical Center, talks about why UMMC is proud to be one of The Leapfrog Group's Top Hospitals for the fourth straight year. It is wonderful to have a major medical center accept the challenge Leapfrog has issued to "trigger giant leaps" in the safety, quality and affordability of health care.

Memphis area hospitals have been national leaders in reporting to The Leapfrog Group's annual Hospital Survey and we have seen progress in the adoption of computerized provider order entry and in staffing intensive care units with physicians trained in critical care medicine. But we still have a long way to go to have a hospital included in Leapfrog's Top Hospital list.

MBGH is challenging Memphis-area hosptials to have at least one hospital on this list in 2011. Let's see which hospital(s) step up and accept the challenge!!

Click here to view the video.

Long List of Concessions Needed To Ensure Passage of Health Reform

Many concessions were made in the final hours to get the 60 votes needed to pass Reid's health reform package in the U.S. Senate. Concessions ranged from:

• Federal funding of extra costs due to Medicaid expansion in certain states
• Exempting certain health plans in specific states from new fees
• Funding the construction of a new hospital
• Exempting certain industries from the new "cadillac plan" taxes
• Special Medicare Advantage benefits in specific states 

Click here to read more details.

Memphis Medical Society Quarterly Magazine Reports on MBGH's eValue8 Project

Read the Winter 2010 edition of the Memphis Medical Society Quarterly magazine's highlights of the results of MBGH's 2009 eValue8 health plan evaluation, starting on page 8 of the pdf.  Click here for an on-line copy of the magazine.

We're Likely to Continue to See a Decline in Small Physician Practices

Atul Gawande's latest article in the New Yorker magazine compares the current health care quality and efficiency crisis to a similar crisis experienced in agriculture in the early 1990s. Gawande points out that improvements in agriculture, driven by scientific and technological advances and evidence-based efficiencies, resulted in farm consolidation and the rise of big "agribusiness". And, the small farmer suffered as they became less competitive with larger, consolidated farms.

Gawande postulates that small physician practices may face a similar situation. Pressures for physicians to consolidate will only increase with the emphasis on performance measurement and outcomes-based payment methologies.Given this direction, we are likely to see the number of small practices continue to decrease.

Click here to read a summary of the article's points on small physician practices.

Click here to read Atul Gawande's complete article.

Senate Democrats Making Progress on Health Reform Legislation

Key new elements of the reform legislation Senate Democrats are sending to the Congressional Budget Office for scoring include:

• Opening Medicare beginning at age 55
• Non-profit national plans administered by the Federal Office of Personnel Management
• Requirements that insurance companies spend 90% of the premium on medical benefits (vs. administrative costs)

These new elements were negotiated by a group of 10 Democrats -- 5 liberal & 5 moderate -- in closed door negotiations. The plan is now being sent to the Congressional Budget Office for scoring and more details will be available once CBO releases their findings.

Technically, the "public option" is off the table, although the term may still be used to describe the expansion of Medicare or the national non-profit plans. However, the public option as originally envisioned appears to be gone.

Click here to learn more.

Mercer Survey Shows Employers Would Cut Benefits to Avoid Excise Tax

Mercer surveyed 465 employer health plan sponsors to find out how they would respond to the excise tax portions of the proposed health reform legislation. Major findings included:

63% indicated they would cut benefits to avoid paying the excise tax. 23% indicated they would pass the tax on to their employees.

75% of those that would cut benefits would do so by increasing employee deductibles and copayments.

52% of all respondents (small, medium & large employers) favor an individual mandate. 65% of large employers (5,000+ employees) favor an individual mandate.

Click here to get more detailed survey results.

Memphis Firms Await Health Reform Scenarios

MBGH's board member, Jane Pienaar of Morgan Keegan, is highlighted in this article covering MBGH's November 24 health reform meeting with Andy Webber, CEO of the National Business Coalition on Health. The title says it all: "Firms await health reform scenarios" before they make strategic changes...

Click here to read the Commercial Appeal article.

No Memphis Hospitals on Leapfrog's Top Hospital List

No Memphis hospitals are on The Leapfrog Group's Top Hospital list for 2009. Only TN hospitals were Vanderbilt University Hospital and The Monroe Carell Jr. Children's Hospital at Vanderbilt. I'm challenging Memphis hospitals to have at least one of our hospitals on this list by 2011. Which hospital(s) want to help make this happen?

Click here to see the entire list of Top Hospitals.

Confused Over the New USPSTF Recommendations on Screening Mammorgraphy?

There has been a lot of media coverage and confusion over the change in the U.S. Preventive Services Task Force recommendations on screening mammography. To get the complete and accurate story, click here to read the full recommendations and rationale for the change.

A summary of the recommendations is presented below, including a quote from Diana Petitti, MD, MPH, Vice Chair of the USPSTF before U.S. Congress on November 19, 2009.

The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms (emphasis added).
Grade: C recommendation. (The USPSTF recommends against routinely providing the service)

"So, what does this mean if you are a woman in your 40s? You should talk to your doctor and make an informed decision about whether a mammography is right for you based on your family history, general health, and personal values."
Diana Petitti, MD, MPH
Vice Chair, U.S. Preventive Services Task Force
November 19, 2009

* The USPSTF recommends biennial screening mammography for women aged 50 to 74 years.
Grade: B recommendation. (The USPSTF recommends the service)

* The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older.
Grade: I Statement. (Insufficient evidence)

* The USPSTF recommends against teaching breast self-examination (BSE).
Grade: D recommendation. (The USPSTF recommends against the service)

* The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination (CBE) beyond screening mammography in women 40 years or older.
Grade: I Statement. (Insufficient evidence)

* The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of either digital mammography or magnetic resonance imaging (MRI) instead of film mammography as screening modalities for breast cancer.
Grade: I Statement. (Insufficient evidence)

MBGH Had a Full House at our Health Reform Update

Andy Webber, CEO and President of the National Business Coalition on Health, updated a capacity crowd at this morning's MBGH "Health Reform: How It Affects Employers" breakfast meeting at the Crescent Club.

Andy focused on the major provisions that impact employers:

• The employer mandate and "pay or play" proposals, including the federally mandated minimum benefit design
• The development of insurance exchanges and the public option
• Excise tax on "cadillac" plans and
• Workplace health promotion incentives.

Andy believes that there will be some type of health reform passed and signed into law by the first quarter 2010, perhaps as early as the President's State of the Union Address in January. According to Andy, there is just no other option for the Democrats but to pass SOMETHING. The exact shape of that "something" is still to be determined, especially the fate of the public option.

Click here for a copy of Andy's slides.

We Need a Holston Medical Group in Memphis!

We need a "Holston Medical Group" in Memphis!!! Blown away at the "Preparing for a New Healthcare Landscape" meeting by the clinical, administrative, & cost outcomes Holston Medical Group has achieved with their emphasis on electronic medical record, team approach to care, and general "accountable care organization" philosophy. Who is willing to do this in Memphis? Can't wait to get Dr. Jerry Miller to Memphis to share his knowledge & inspire change...

Hot Off the Press at the NBCH Annual Conference

The Annual Conference of the National Business Coalition on Health has just concluded and it was the best conference yet for NBCH. Timing could not have been better with the House passing health reform on the Saturday night before the conference began on Sunday morning. But this conference did not focus on national health reform (although clearly there was plenty of buzz and even a session or two on it), but on the fact that real health reform is happening in local communities, such as Memphis, and that it will take a long time for national reform to really change what happens at the local level. Here are some of the key take aways from the Conference:

Employer Payment Options:

The national health reform we appear to be getting is not payment reform, so employers will have to do that ourselves.

There is no one-size fits all in payment reform methodology because each market's health care delivery system infrastructure is different and applying one method across the country could result in dire consequences. In Memphis, for example, reference pricing may be something for us to consider since we have a consolidated hospital market, where in other markets other market-driven approaches may work better

Reference pricing (tying what an employer pays to the most efficient provider's price within a market) was the most discussed payment methodology that could be implemented today. Safeway and other major employers are already doing it with their health plans. Key issue is defining the "market" which most suggested would be much larger than the traditional market definitions for tertiary services such as heart surgery, knee surgery, etc (not primary care or chronic care management). In Memphis, maybe we include Nashville in our market? This approach means that we would be expanding the market for where we “incent” our employees to go for care, but it may be an approach worth considering if pricing becomes too high locally and quality is either equal to or below what our employees could get elsewhere.

Accountable Care Organizations (ACOs) operated by hospitals that end up "consolidating" hospitals and medical staffs would limit referral patterns and probably increase prices, and therefore costs, because of increased bargaining power. In Memphis, this could be possible if either Methodist or Baptist consolidated with their medical staffs. We would want to be sure that employers reaped the clinical/outcome benefits of this consolidation at a reasonable cost. We would want to consider packaging this approach with reference pricing to be sure prices did not get out of control..

Employer Benefit Design:

We should move toward value-based benefit design (which we have started in Memphis) and then to value-based payment.

You can say no then say yes, but you cannot say yes and then say no. In other words, it is easier to say yes to something you have denied in the past vs. taking away something you have given in the past. Applying this to benefit design, be strict on the front-end and say yes to those services/benefits that are evidence based (and provide them at no cost to the employee) and no to everything else (or assign a very high copay). Then, as the evidence becomes clear that something is effective, enhance coverage.

Public Reporting:

We need to move toward measuring and reporting whether "appropriate care" was provided. Move from measuring gross volume and outcomes to whether the right people got the right care...a very different paradigm. This will address employers’ concerns about “over-use” and “waste” in the system and help ensure that employers only pay for the right care.

Health Reform:

If the public plan is structured where it is on a level playing field with commercial plans, why do we need it?

The AHA seemed to imply that hospitals are "too big to fail" because of their tax free bonds that have not yet been paid....Probably a message being delivered to Congress quite regularly.


I am sure there is much more to share, but these are the highlights. Great meeting and great speakers...Great thinking for us in Memphis on how to deploy some of these strategies to improve the cost and quality of health benefits!!!

How Do We Save the Med?

The discussion on how to save the Regional Medical Center at Memphis (the Med) is heating up. The Med's Board has indicated that it will close the emergency room, 70 medical/surgical beds, and outpatient clinics if $32 million is not found by February 2010.

An idea floated by Shelby County Commissioner Mike Ritz is to add a 2% tax on all hospital services in Shelby County (click here). A letter to the editor from Gary Shorb, CEO of Methodist Healthcare calls for "public support" of the Med (click here), but is unclear as to what form that support should take. Gary Gunderson and Scott Morris, in a special Viewpoint column today (click here), call upon us to "pray with all of your might for the health of our city, for those who will be affected if The Med emergency room is closed. We also call on all to pray for the strength to make wise decisions that will lead Memphis to be a city where rich and poor alike have the benefit of being cared for when we are most vulnerable."

This last call by Gunderson & Morris is a call to action to make "wise decisions". But what is the wisest decision? To burden those who are paying the high cost of health care by adding an additional 2% tax to their already high bill could have dire unintended consequences. One of those consequences could be pricing health care services out of reach of even more people, adding to the community burden of the uninsured. The call for public support could possibly take the form of a broad-based strategy to raise revenue for the Med. After all, if it is indeed a community resource or "utility" then don't we all have a role to play in keeping it viable?

One last thought: as I wrote to the CA back in August 2008 (click here), the Med owes us something in return for our financial support. It owes us a well-run, efficient hospital offering our community the highest quality care for the services it provides. As Gary Shorb points out, the Med has made progress in these areas. However, the Med should make a commitment to be held publicly accountable for the cost and quality of their care by agreeing to publicly report their progress in implementing critical patient safety and quality improvements by reporting, like the other Memphis-area hospitals, to The Leapfrog Group Annual Hospital Survey (click here).

We are being asked to dig deep into our pockets as citizens to support the Med, and the Med should prioritize showing us that it is worthy of this support.

Purchasing High Performance Newsletter Now Available

Memphis Business Group on Health announces the release of the latest edition of "Purchasing High Performance", a newsletter designed to help employers manage the quality & cost of their health benefit plans. Great articles on health reform, employer best practices, employee incentives, health delivery system reforms and more.

Click here to access the newsletter.

MBGH Comments at NCQA Press Conference Cited in Modern Healthcare

Modern Healthcare covered the NCQA press conference releasing their 2009 State of Health Care Quality Report and noted MBGH's CEO, Cristie Upshaw Travis' comment on how, in Memphis, MBGH and our members expect plans to collaborate to improve health status:

"Fostering greater collaboration among health plans will help reporting initiatives, said Christie Travis, CEO of Memphis Business Group on Health. “We expect our plans to work together,” Travis said during the conference. The business group is working with three commercial health plans to aggregate patient data in Tennessee and evaluate it for improvement targets, she said."

You can access the NCQA report by clicking here.

MBGH to Present at GMEBC on November 5!! Plan to Attend.

MBGH's CEO, Cristie Upshaw Travis, will present at the November 5, 2009 meeting of the Greater Memphis Employee Benefit Council. She will speak to:
Value Based Benefits: Aligning Health Benefits with the Total Picture for your Company.

PLACE: The Crescent Club
6075 Poplar Ave

TIME: 11:30 A.M. Registration
11:40 A.M. LUNCH (served immediately upon arrival)
12:15 P.M. Program

COST: Please note: If you are not a member of GMEBC, you will need to pay the non-member fee.
$30.00 per person for GUESTS and NON-MEMBERS Of GMEBC
(Cash or Check, which is payable at the meeting)

RESERVATION Friday October 30, 2009 (by Noon)
DEADLINE: Call: Leigh Ann Alexander 901/820-5829
Email: leighann.alexander@fedex.com

Reservations are required for members, non-members and guests. We greatly appreciate your timely response.


CANCELLATION Monday, November 2, 2009 (by Noon)
DEADLINE: Cancellations must be received by the above deadline to avoid meal charges, or you can send someone in your place. This applies to members, non-members, and guests.

Pennsylvania’s Public Reporting of Hospital Outcomes: A Potential Model for Improving Value

From Avalere's Evidence Based Medicine Update:

A recent Wall Street Journal article highlighted Pennsylvania’s twenty-year history of publishing hospital outcomes as a potential model for improving quality and lowering costs nationally. Since 1986, the Pennsylvania Health Care Cost Containment Council (PHC4) has publicly reported death and complication rates for all Pennsylvania hospitals. The state has found that high-quality treatment usually results in reduced costs manifested in shorter hospital stays and fewer readmissions. Large Pennsylvania employers, such as Hershey Co. and the Philadelphia Police Department, have used PHC4 data to offer health insurance options that steer their employees toward only the highest performing hospitals, producing significant savings. The Senate Finance Committee’s health reform bill would allocate up to $75 million annually to develop methods to improve quality, which could include published hospital outcomes. PHC4 critics claim that the data is imprecise and not comprehensive enough to account for the sickest patients who are seen primarily in academic medical centers. However, the article quotes Jon Blum, Director of the Center for Medicare Management,stating that “there is a clear understanding in the Obama administration that both Medicare and Medicaid need to move in the direction of what’s happening in Pennsylvania.” The article can be read by clicking here.

MBGH is in DC This Week

MBGH is visiting the Hill to explain that poor transitions of care cost employers unnecessary dollars & result in poor quality of care for their employees/families. MBGH will also participate in NCQA's Press Conference releasing their latest State of Health Care Quality report. We will comment on the importance of health plan performance reporting, but stress that employers also expect improvement, which employer coalitions lead in Memphis & across the country.

How Does Your Health Plan Cover Extra-Healthcare Facility Fees?

Does your health plan cover facility fees for outpatient services provided in hospital-owned physician practices? Private physician offices can't charge these fees, but hospital-owned physician practices are able to charge for facility use. As this article explains, these charges can cost your health plan and/or your employees significant dollars. Several issues are important: Knowing there is a facility charge and the amount of that charge; knowing whether your plan covers it or your employee will have to pay for it as an "uncovered" cost. Many people are being caught completely off guard when these fees show up on their bill. Knowing that there is a charge and what it is, is certainly the first step that is needed.

Finally, since private physicians cannot pass along a facility fee, should you consider "incenting" your employees to use private physicians? Share your ideas with MBGH so we can see what your thoughts are on this issue.

Click here for the Washington Post article.

Has your worksite adopted the "Fun Theory"?

According to www.TheFunTheory.com: "Take the stairs instead of the escalator or elevator and feel better” is something we often hear or read in the Sunday papers. Few people actually follow that advice. Can we get more people to take the stairs over the escalator by making it fun to do? See the results here."

MBGH Hosts Health Reform: How Does It Affect Employers?

Andy Webber, President/CEO of National Business Coalition on Health, will be in Memphis on November 24, 2009 to bring us the latest, hot off the press information on health reform, focusing on how reform will impact employers. Click here for additional program & registration information.

Leaving Dallas with my head swimming over Baylor's "Southern Sector Health Initiative"

I learned that Baylor healthcare system has an equity project in South Dallas that is partnering with City of Dallas using a parks & rec facility to create a "medical mansion" (vs. a medical home) that will integrate health, wellness, recreation, medical care and focus on the social-determinants of health as well as health care. WOW!!!! Could we do that in Memphis too?

Click here to read more on this project.

MBGH in the News

MBGH CEO, Cristie Upshaw Travis, featured in Memphis Medical News "Leaders in Healthcare" series.

Click here to read the article.

Congressional Budget Office Issues Finding on Senate Finance Health Reform

CBO issues finding that Baucus bill results in $81 billion REDUCTION in the Federal deficit in 2010-2019. CBO letter is a good outline of the Finance Committee's final bill as well as the financial implications.

Click here to read the CBO letter

Update on 10.02.09 Senate Finance Committee Health Reform

Get the latest on Senate Finance Committee legislation from Business Insurance/Reuters
http://ping.fm/Z9VQd

Four Reasons Why Meaningful Health Reform is Unlikely To Pass This Year - healthplans.hcpro.com

According to Les Masterson the reasons include:

There aren't enough uninsured (although this could change)
There aren't enough doctors to care for 47 million uninsured
Public option will pay docs less
Public won't support taxes to pay for reform

Four Reasons Why Meaningful Health Reform is Unlikely To Pass This Year - healthplans.hcpro.com

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MBGH Releases Guide to Planning & Implementing a Worksite H1N1 Program

Get answers to key questions about planning & implementing a worksite H1N1 program including:

Who should receive the H1N1 vaccine?
How does an employer obtain the H1N1 vaccine for the worksite?
What are the key messages employers should share with employees?
How should sick leave & other policies be adapted?
Are their special contamination & cleaning processes that should be implemented?
Where are credible resources for additional information?


MBGH Reports Worksite H1N1 Program Complete

Marsha Blackburn on Cost Shifting & Crowd Out of Private Plans

TN's Marsha Blackburn breaks down how public programs that do not pay providers adequately results in cost shifting to employers and others in the private sector & describes how a "public option" could crowd out private options.

Click here to watch the video. You can watch more highlights of her presentation at this site as well.

How Do You Cover HIV Screening for High Risk Beneficiaries?

Review how your coverage compares with CMS (Medicare) proposed coverage for HIV Screening.

On September 9, 2009 CMS proposed to cover annual HIV screening for certain Medicare populations, including any beneficiary who requested the service, all pregnant women, and individuals who have engaged in certain high-risk behaviors. This is the first time CMS has used new authority granted under MIPPA to cover new preventive services using the national coverage determination (NCD) process. Before MIPPA, CMS could not cover new preventive services without Congressional action. The new policy stipulates that CMS must cover preventive services that are reasonable and necessary for prevention or early detection of an illness, Grade A or B-recommended by the U.S. Preventive Services Task Force (USPSTF), and appropriate for Medicare beneficiaries. MIPPA also granted CMS the authority to use cost-effectiveness analysis to determine coverage for a preventive service. HIV screening received a Grade A recommendation from the USPSTF, and CMS concluded that recurrent HIV screening is economically favorable for populations with higher incidence of HIV. Comments are due October 9. A final coverage decision will be made by December 8.

Go to CMS HIV for details.

CDC Guidance for Small Employers re: H1N1

CDC's Lisa Koonin, featured in this video, recently participated in MBGH's national webinar on employer preparedness for H1 N1.

MBGH Releases 2009 eValue8 Report

MBGH released our 2009 eValue8 report at our Annual Conference, "Do It Yourself: Health Benefit Tools for Employers", on August 26, 2009. This year BlueCross BlueShield of Tennessee and CIGNA participated. Next year we will once again report on all 5 major commercial health plans in Tennessee.

This report shows that both BCBST and CIGNA made improvements in identifying and tracking members for program participation and in notifying members of needed or missed services, otherwise called gaps in care. However, there is still significant room for improvement in all of these aspects.

Although there was improvement in some aspects, it was surprising that both plans were at or below the 25th percentile on key HEDIS measures for childhood immunization, well care visits for ages 3-6, adolescent visits, and behavioral health. MBGH will be working with these plans over the next year to identify interventions to improve these HEDIS scores.

Share your thoughts on this eValue8 report and health plan performance in TN by posting comments to this blog. You can see the entire report by clicking on the link below.

2009eValue8

Fred Smith's Comments on Health Reform

Memphis' own, Fred Smith, addressed health reform on Fox News Sunday today. Basically, he stated that there has to be reform. Those that cover their employees, such as FedEx (and all other MBGH members), are paying for the un-insured since the health care delivery system does not deny medical care. He proposed that we should have mandated coverage for "major medical" or "catastrophic care", which was the type of insurance many of us had in past. He commented that at one point, there was not "first dollar coverage".

Fred Smith was joined by Steve Odland, CEO & President of Office Depot and former CEO and President of Memphis-based AutoZone, and John Chambers, Chairman & CEO of CISCO Systems.

MBGH Hosted Successful Employer Preparedness Webinar re: H1N1

MBGH just finished hosting a national webinar on Employer Preparedness for H1N1. The webinar was coordinated through the National Business Coalition on Health and over 140 coalitions and employers from across the U.S. particiapted. Presenters included Lisa Koonin, Senior Advisor for the Influenza Coordination Unit of the Centers for Disease Control and Prevention and Liz McKee of Baker Donelson and Salomon Mizrahi of Frist Horizon, both MBGH members. A summary of the webinar and links to presentations and webinar recording will be posted soon, so check back. If you have any questions, contact Cristie Travis at ctravis@memphisbusinessgroup.org .

A Call I Can Finally Answer

A friend of mine called last week to ask for suggestions for a cardiologist and a cardiac surgeon. Her husband’s father had been admitted to the ICU and they determined that he needed a cardiac cath and possibly surgery. She reached out to me because she knows that Memphis Business Group on Health has been collecting information on the quality and efficiency of cardiac care in Memphis since 1997. She also knew that we had worked with physicians, including cardiologists, to help them evaluate the quality of care they gave their patients and to see if they met national standards. She knew that my father had practiced medicine in Memphis for 45 years and had referred me through the years to the physicians he knew would give me good care.

In the past, all I would have had to share with her was this “insider” information. Information that was not generally available to everyone in Memphis, but information I had because of my job and because of my family. One of the well-kept secrets in health care is that insiders know who the good doctors are but that information has only been available to those "in the know".

Well, today I am excited that we are beginning to “democratize” healthcare!!! No longer do you have to be an insider to get some credible information on our local physicians. I was able to refer her to www.healthymemphis.org and tell her to scroll down and click on “Patient Experience Survey” to go to the Consumer Checkbook survey results for over 400 Memphis-area physicians, including cardiologists. These results are based on perceptions of care gathered from thousands of Memphis-area residents about their physicians. I was also able to refer her to www.NCQA.org where she could click on the link “Recognition Programs” to see the list of cardiologists in Memphis that have voluntarily submitted information for evaluation and have been recognized for the quality of care they provide.

I am glad I can finally answer a call looking for a good physician by referring a friend to credible information. I hope my friend followed-up and used this information as well as information she gathered from her father-in-law’s primary care physician and other friends and family. Having this type of information publicly available to everyone, not just health care industry insiders, is a huge step in helping make quality care available to everyone in our community. But having this information will only help if we begin to use it. So, check the sites out yourself and let me know what you think.

Make Your Own Health Reform

In the midst of all of this health reform hubbub, I was struck by the simple message of an article by Rick Johnson for HealthLeaders Media, published July 28, 2009. He states:

"But whatever comes out of the other end of the health reform debate, insurers and employers should not count on the eventually watered down version of health reform - assuming some plan actually becomes law - to help change the direction of healthcare's cost curve. No, it is wiser to exhaust the tangible options at hand. A truly progressive employer is striving today for a mix of employee wellness efforts and contracts with health care organizations - both at home and abroad - that bring down the cost of some of the most pricey and common procedures....One day this health reform movement seems to gain momentum, and then the next day it loses traction..... So work today to bend your organization's cost curve. No one is going to do it for you tomorrow."

When we developed the theme for our recent August 26 conference, "Do It Yourself: Health Benefit Tools for Employers", we didn't know the twists and turns health reform would take. As it turned out, that was a perfect theme as the conference focused on what Memphis-area employers CAN do to bend their own cost curve. Actions around benefit design, vendor management, work site clinics, and activating your employees are all within your realm of control. You don't have to wait on Congress for changes in these areas. You don't have to wait for the health care delivery system to improve quality and become more efficient to take these steps.

Put these strategies that employers can do now together with local efforts to measure and report on provider performance, create systems to help providers improve the quality and efficiency of their care, and engage consumers across the whole community, and we have a recipe for our own local health reform.

Let's learn more together about ways we can bend our own cost curve and reform our own system and not wait for the federal government to make that happen. The more of us that take these types of actions, the faster we will see the difference.