Why do we pay more money without getting better quality care?

Value is one of the most important missing topics in the health reform debate.

We might not be so concerned with how much health care costs or how much of our national budget gets devoted to health care, IF we felt we were getting good value for our money. But the fact is that we all know we aren't getting a good value. We see prices continue to rise faster than inflation and very often that is accompanied with lower levels of service, less time with our doctors, etc.

There have been some studies focused squarely on this issue. I have commented before on the Health Affairs article last year.

Now comes a nice report from Massachusetts that examined the costs of healthcare and how they relate to quality.

What did they find?

Their preliminary review revealed serious system-wide failings in the commercial health care marketplace which, if unaddressed, imperil access to affordable, quality health care.

Their investigation has shown:

- Prices paid by health insurance companies to hospitals and physician groups vary significantly within the same geographic area and amongst providers offering similar levels of service.

- Price variations are not correlated to (1) quality of care, (2) the sickness or
complexity of the population being served, (3) the extent to which a provider is
responsible for caring for a large portion of patients on Medicare or Medicaid, or (4) whether a provider is an academic teaching or research facility. Moreover, (5) price variations are not adequately explained by differences in hospital costs of delivering similar services at similar facilities.

At The Healthcare Blue Book our work with employers reveals this fact frequently. We routinely see employees paying 500% more than necessary for common services while getting no better (and sometimes lower) quality of care. These are prices paid to in-network providers; and prices that ultimately are paid for by the employer under their health benefit costs.

The more research the better, but each study points in the same direction: there is a lot of opportunity for employers and employees to lower costs and raise quality.