Information about quality is beginning to be considered by some employers as they make purchasing decisions about health care, particularly care provided in hospitals. It's data that wasn't always relevant in Wichita in previous years, when insurance plans directed their members to one hospital or another.
But the new federal health care act emphasizes data, and many employers now offer insurance that allows their employees to choose which hospital to use, so quality becomes more important.
Ron Whiting, executive director of the Wichita Business Coalition on Health Care, has prepared two data briefs for coalition members.
"Do we assume that all hospital care is of the same quality?" he asks in the first. "Is hospital care something we should purchase based strictly on price?"
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No and no.
"The quality is assumed to be all the same," he said. "There's just not thought given to it.... There's very little questioning about outcomes."
In Pennsylvania, employers have been using hospital quality data from the Pennsylvania Health Care Cost Containment Council since the mid-'80s.
It is widely accessible and shows employers, consumers and insurers which hospital had the shortest average stay for heart attack medical management, for example, and that the hospital also had the lowest average cost along with an average mortality rate. Similar information is provided for a number of diagnoses.
Stephanie Suran, communications manager for the council, said in an e-mail that business and labor leaders have used the data to improve quality and restrain costs.
The Law Enforcement Health Benefits Trust uses council reports to steer members to hospitals with high-quality outcomes, she said. The Delaware Valley Health Care Coalition is using it to create a hospital centers of excellence preferred provider network. The Hershey Co. cut expenses by offering workers coverage based on outcomes.
A study also showed that patients in Pennsylvania had lower odds of dying in a hospital than patients in other states where hospital reporting wasn't as intensive.
Locally, employers are just beginning to learn what data is available.
Whiting said he's trying "just to open people's eyes" about the data.
Catherine Holdeman, assistant city manager, said, "We are now in a time period where we know enough to know the questions we should start asking.... It's kind of been a learning curve."
Whiting said it's rare that one hospital scores high across the board, and scores can have as much to do with physicians as with a hospital.
Mathew Mount, controller at Wescon Products, said his company is looking at using a specific physician group to get the value and quality it wants from primary care providers.
"We're in the early process," he said, and not yet sure how the idea will play out.
But Shannon Krysl, director of employee benefits and insurance management for Wichita schools, said employers "have to move away from paying for sick care."
She said, "I think there's a shift going on" among employers who recognize the current system isn't working. "We've got to find a new way to pay for performance, pay for outcomes."
Whiting said employers purchase other supplies based on specifications or use Six Sigma tools for making decisions. But "that's one element of purchasing to quality that we don't see very much in health care."
The business coalition and others have an initiative called Healthy Wichita: Leadership by Example, and part of it involves a survey of participating executives. One question is whether the company reviews quality of care as part of its benefits strategy.
"Everybody is saying 'no' so far," Whiting said. "It then begs the question, well, what are you buying?"
Hospitals already are required to report quality data. Donald Berwick, who heads the Centers for Medicare and Medicaid Services, is likely to push for more physician data as part of the Affordable Care Act and incentives for medical providers to adopt electronic health records.
Those measures should make data more widely available.
"Spirit believes that the evaluation and reporting of healthcare quality measures is increasingly important," Spirit AeroSystems senior vice president for human resources Gloria Farha Flentje said in an e-mail.
"Without this information, neither employer nor employee can obtain optimal value for the healthcare dollar."
Whiting said, "Every time I talk about quality, I hear a thousand reasons why providers have problems with this stuff.
"But we've got to start down this path."