Quality of care isn’t a deal clincher for companies choosing workers’ health coverage, according to insurance brokers and consultants.
It’s cost and network size that are the ultimate keys, though quality “is going to become more important (in the future),” said Ron Mason, health and welfare practice leader at consultant Towers Perrin Tillinghast’s Irvine office.
Mason expects report cards and other quality measurements to become more important as the “consumer-driven” healthcare concept takes off.
But providing information on hospital quality is necessary to help employers change how they deliver health plans, Mason said. He also said that getting quality information out to workers would help in making them more accountable.
For Karen Nixon, a Corona del Mar insurance broker, clients tend to see a hospital network’s breadth as a factor, as well as perceived quality, in picking a health plan. Nixon’s clients, she said, want enough hospitals in their network to give their workers choices for where they can go for treatment.
Quality measurement topics have been thrown about in healthcare for the better part of 10 years, but are gaining more attention thanks to the nascent “healthcare consumerism” movement. Healthcare consumerism aims to get workers to buy health services based on price and quality, similar to what is done in other segments of the economy.
If that happens, poor performing and overpriced healthcare providers could be weeded out, which in turn could help cut rising healthcare costs, observers said.
So various groups, including health plan operators such as Cypress-based PacifiCare Health Systems Inc., the Joint Commission on Healthcare Accreditation, Health Grades Inc., Leapfrog Group, Pacific Business Group on Health and even U.S. News and World Report, are rushing to supply information about hospital and doctor quality.
A recent example comes from Health Grades, which released a report card on stroke care in U.S. hospitals. The Lakewood, Colo.-based consultant used mortality data from the federal government to come up with its ratings.
Two local hospitals that received top five-star grades for their stroke care: Long Beach-based Memorial Health Services Inc.’s Orange Coast Memorial Medical Center in Fountain Valley and Santa Barbara-based Tenet Healthcare Corp.’s Fountain Valley Hospital Regional Medical Center.
Orange Coast uses rankings as part of an overall quality initiative that involves working with its physicians, said Marcia Manker, the hospital’s chief executive.
“We use these reporting tools as a guide that we can track our progress against,” Manker said. “Do I like having a five-star designation? You bet, but regardless of the score we get in any of the surveys, we’re always going to strive to improve.”
Meanwhile, UCI Medical Center, a teaching hospital in Orange, landed a berth on U.S. News & World Report’s 2004 ranking of America’s best hospitals.
UCI ranked No. 22 for gynecology and No. 45 for geriatric care in the analysis, which also looked at other types of care, including cardiac and neurology treatment.
While healthcare quality may be generating buzz, the movement still is in its infancy and will improve, said Dr. Eugene Spiritus, UCI Medical Center’s chief medical officer.
“People have been looking for ways of defining quality for years,” Spiritus said. “What’s happened is that there have been multiple surveys looking at multiple issues. They’re driven by different points of view and different metrics.”
Spiritus said interest in ratings has heightened because of rising healthcare costs, competition and increased concern about medical errors.
New Hoag Chairman
Hoag Memorial Hospital Presbyterian in Newport Beach has a new chairman: Richard Ortwein, partner and founder of Focus Real Estate LP in Irvine.
Ortwein, former president of Koll Development Co., replaced Dick Allen, who headed Hoag’s board of directors for the past six years.
Meanwhile, John Benner, a resident of Newport Beach who is a consultant to international businesses, small companies and nonprofits, was elected to the 19-member Hoag board. Benner fills a vacancy from the retirement of Gary Gray, who served on the board for nine years.
Bits and Pieces:
I-Flow Corp., Lake Forest, said it won a court ruling that allows Medicare payment for its On-Q pain relief device following hernia surgery. The device maker said that in the wake of the case it would ask Medicare contractors to revise their coverage policies and begin to pay for using On-Q for post-operative pain. Separately, I-Flow Chief Executive Donald Earhart spoke on its growth strategy and market opportunities for regional anesthesia at the SG Cowen & Co. global healthcare conference in Geneva … Mission Hospital, Mission Viejo, said that an 83-year-old female patient received a Vitatron T-series advanced digital pacemaker last month. Dr. David Kawanishi, who practices with MIMG Cardiology in Mission Viejo, implanted the device, which is made by Medtronic Inc. Mission said it was the first such pacemaker implanted in a California patient.
