Committee for a Responsible Federal Budget

Health Care Solutions that Work in the Real World

Oct 19, 2012 | Health Care

This morning, the National Coalition on Health Care held a forum in the Rayburn House Office Building entitled “Innovations in Health Care Delivery and Benefits: Real World Solutions.” The forum highlighted three success stories in improving quality and lowering costs in the delivery of health care. In policy discussions held in Washington around reforming federal health spending, real world successes and examples are often left out of the conversation. NCHC’s forum reminded us that there are providers, plans, and employers working to aggressively improve outcomes and reduce costs in the current health care system today

The forum began with Joelle Frizzera, Clinical Services Manager at Evercare Mid-Atlantic, who talked about her work implementing a successful nurse practitioner program which reduced unnecessary hospitalizations and improved patient satisfaction. Frizzera's model demonstrates that medical expense management and coordinated care efforts paid off in decreasing hospitalizations that contribute to the excessive spending in our health care system.

The next speaker, Bill Estabrook, provided another example of innovation and commitment to improving care delivery and simultaneously reduce costs, but from an employer’s perspective. As Executive Director of the Ohio Police and Fire Pension Fund (OP&F), Estabrook started the Diabetes Prevention Program, a community-based health education program to help those who are at risk for diabetes. Estabrook himself actually participated in this program once he learned he was pre-diabetic and credits the program for his personal health improvements. As a result of this program, OP&F’s health care costs were 16% less in 2012 than they were in 2011. Nationally, programs like this can lower the rate of diabetes onset by over 30 percent.

The last speaker was Dr. Jerry Penso, Chief Medical and Quality Officer at the American Medical Group Association (AMGA). AMGA has taken a number of innovative approaches to lower costs and improve quality through various provider and consumer incentives. Dr. Penso mentioned one example where they were able to reduce preventable readmissions for patients with cardiac failure (the number one reason nationwide for readmissions) by better tracking their recovery with care coordination and health information technology, saving an estimated $2 million dollars.

Overall, these examples provide real evidence that savings can be achieved through certain delivery system reforms. As lawmakers return to Washington next month and face a multitude of decisions to address the fiscal cliff and our mounting national debt, lessons learned in the private sector can be useful in not only reducing federal health spending, but also in improving actual health care outcomes and lowering costs in the health care system more broadly.