Good Quality Improvement Programs Produce Better Bottom Lines

W. Edwards Deming once said, "In God we trust, all others bring data!" That is just what I propose to do in this newsletter. I often speak of how continuous quality improvement programs improve the bottom line at a healthcare site. This idea is throughout my web site. I promote the idea that "Quality pays, it does not cost." That is, a good quality improvement program based upon population level data not only is not cost neutral, it improves the income and profit at a site. Many healthcare professionals do not believe this. They point at all the regulatory standards for quality, such as those written by JHACO, and believe that quality is actually costing them quite a bit. I have done some extensive research on this topic recently and believe that I can prove this point convincingly to you.

Fortunately there is good documentation of financial outcomes at healthcare sites which use various quality improvement approaches. I am very familiar with two of these-TransforMed's National Demonstration Project and the Federal Government's NIST (National Institute of Standards and Technology) Baldrige Award program. Starting in 2006 TransforMed, a subsidiary of American Academy of Family Physicians, began a program to aid in transforming a sample of primary care practices into models of the Patient-Centered Medical Home (PCMH). One group of sites was actively involved with representatives from TransfoMed to adopt the Patient-Centered model and the other group used materials supplied to them by TransforMed to use in a self-directed approach to adopt the model. TransforMed's CEO, Dr. Terry McGeeney, wrote an article recently (available on the TransforMed website) summarizing the financial impact of the adoption of the PCMH. The results were very positive. The revenue for the assisted sites rose 10.49% on average and the rise in revenue for the self-directed sites was 2.43%. For physicians at these sites personal income rose nearly 14% at the assisted sites and 13% at the self-directed sites. This was achieved while most of these practices were installing electronic medical records. These results are well documented because of TransforMed's practice change model incorporates strict tracking of financial data.

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I am familiar with one such site here in West Michigan that has seen its bottom line swing from the red to the black because of its involvement with the TransforMed national project.

The Baldrige Award is given out each year to competitors in manufacturing, small business, education, healthcare and nonprofits. Those competing for the award must document continual quality improvement in a variety of categories. For healthcare providers there must be demonstrated improvement and achievement in healthcare outcome, patient and other customer-focused outcome, financial and market outcomes, workforce-focused outcomes, process effectiveness outcomes and leadership outcomes. In 2002 SSM Healthcare in St. Louis, the first healthcare recipient of the Baldrige Award, noted that it was able to maintain a AA credit rating over 4 years as it worked on the goals of the Baldrige Award. It increased its market share in St. Louis from 13% to 18% while three of its competitors lost ground. It has also been able to maintain its goal of contributing at least 25% of its operating revenue to charity care at its site. This is very impressive, given today's marketplace challenges.

Another healthcare recipient, Mercy Health System of Janesville, Wisconsin, maintained its AA bond rating since 1989, all the while growing from a stand-alone hospital to a fully integrated system with three hospitals and 64 outpatient service facilities. In 2007 Mercy Health Systems was given a rating of positive long term outlook by Moody's rating service.

This summer Modern Healthcare released a report prepared by Thomas Reuters Center for Healthcare Improvement focusing on the CMS's Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey of patient satisfaction. The intent was to see if the 'happiness' as measured on the survey improved the bottom line. The report stated that there was not a strong direct correlation between the two measurements but that the hospitals with the best scores on the survey did generally have significantly better bottom lines than those who did not. Those with significantly better satisfaction scores did achieve significant results in core metrics other than financial. For instance, most reduced significantly patient-waiting times for discharge. Patients don't like to wait for discharge and tend to be more dissatisfied when they do. When discharge time is minimal, then the cycle time for bed use is reduced and income per bed increases, thus improving the bottom line. Another measure of patient satisfaction relates to personal care. Hospitals with higher nurse to bed ratios show generally improved patent care and attention. According to J.D. Powers those with higher ratios also have a better bottom line. Those with an average of 1.19 nurses per patient bed had an average operating margin of 0.64%. Those with a ratio of 0.91 nurses had a negative 0.27% operating margin.

These three examples provide ample illustration, I believe, that good continuous quality improvement programs improve the bottom line. Those who use professional assistance in their improvement efforts earn a better bottom line improvement, as illustrated in the TransforMed example. The American Society of Quality at its website has several good samples of better bottom lines with quality improvement efforts; there is usually at least one article each month in its flagship publication Quality Progress which details an improvement effort at a healthcare site. My illustrations along with a variety of other resources available online prove that "Quality pays, it does not cost."

Good Quality Improvement Programs Produce Better Bottom Lines

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Cancer Rate Starts Dropping - A Better Health Care Policy?

After many years of medical research on cancer, the new statistics are finally showing promising results. Is this the effect of a better health care policy or just technology? One answer we know for sure is obvious: a better treatment. Moreover, the rate of more precise cancer diagnoses is also climbing due to latest medical technology,so treatment becomes more effective.

But is health care insurance tax raising together with cancer treatment's efficiency? One fact we know for sure is that technology is costly, and research improvements cost money, so medical insurance companies and labs need to cover their investment so unfortunately they need to raise medical taxes.

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However, 2008 year's ARNC(Annual Report to the Nation of Cancer) reveals that for both men and women the incidence of cancer dropped for about 0.69% last 5-6 years, but in case of men the rate is dropping faster than women, which means they are more vulnerable .Of course, nowadays the problem with cancer's treatment is affordability. Barack Obama is now fighting for a new and better medical system, which will involve reasonable prices for everybody, as far as medical care expenses are concerned. Barack Obama's new plan for insurance companies seems like a cutting edge revolution in medical domain, which I am sure not only companies but medical labs as well will embrace.

If you happen to be in that moment when you have to shop for your own health insurance policy, it is kind of difficult especially nowadays when process are very high. Reading a lot of insurance publicity will not give you any clue about your choice. One possibility is, as you probably know on the medical coverage market, the choice between a PPO and HSA health plan.

A Preferred Provider Organization (PPO) health plan is actually a network of many medical providers.An insured has access to a hospital, doctor, any medical facility, which is provided my this network. The network respects a set of rules, regarding the medical service's quality, limit costs and the imposed conditions. Another advantage is that the insured benefit of the highest levels of coverage through this network. Moreover, in case of urgent or unexpected circumstances the network can cover you medical care expenses.

The second package would be Health Savings Account (HSA) , includes to plans. One , the main plan, or major, which covers most medical expenses including costs with a certain limit. It is very possible that a HSA may even have a PPO plan ass well. The second plan refers to savings account which gains reasonable interests and may cover in a certain limit medical care expenses if the first plan failed to succeed. This is the case when more costly medical services are required, for instance cancer treatment.

And finally ,of course which one of the plans is better? PPO or HSA? The decision belongs to each one's budget. HSA is more expensive but provides almost twice benefits than PPO.

Cancer Rate Starts Dropping - A Better Health Care Policy?

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Durable Nanocomposite Filling Improvements May Better Prevent Decay For Long-Term Cheap Dental Care

Although dentists hope that their work will last a lifetime, in reality, restorative appliances such as crowns, bridges, dentures, and fillings will often require additional repairs or replacements over time. Amidst the chewing, grinding, biting, prying, and just plain accidents that involve many people's teeth, it is very difficult for most to keep restorative dentistry work in place over the course of a lifetime.

This need for expensive filling, bridge, and crown replacements makes cheap dental care much more difficult to find. Do you know that Americans spend over billion each year to repair failed or worn down restorative dentistry? Given this large expense, cheaper repair of failed fillings and other restorative work is a necessity for most patients. A developing nanocomposite technology, however, may be a help.

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Traditional Filling Methods

One restorative procedure which commonly has to be reworked is a filling. Fillings are designed to not only fill cavities, but to prevent them from spreading - resin-based composite ones are typically equipped with an anti-decay agent.

Resin-based composites contain a delicate balance of this agent and the material which keeps the filling solid. If too large a proportion of the agent is used, your filling will not be as rigid, and may end up falling out overtime. However, if not enough of the agent is used, decay can may continue spreading behind the cavity, further into your tooth. If this decay continues to grow, it will eventually spread outside the size of your filling, which will also cause it to fall out. For the longest-lasting, most cost-effective treatment possible, there needs to be a way to make a natural-looking filling more secure, while keeping it resistant to decay.

(Amalgams, the silver-colored fillings dentists traditionally used until recent years, are becoming less and less popular due to their unnatural appearance and concerns about possible Mercury poisoning. However, their two key advantages are increased durability and cheaper cost compared to resin-based composites.)

New Nanocomposite Technology

In order to cut down the cost of having fillings reworked, there is an emerging technology which may present a happy medium between the strength of amalgam fillings and the appeal of resin-composite ones. This technology involves a way to create anti-decay particles much smaller than originally possible in resin-composite fillings. Since these "nanocomposite" particles can be a fraction of the size of traditional anti-decay particles, less material is needed to create the same amount of cavity coverage.

If these nanocomposites are used to enhance or replace resin-based composites, the use of more concentrated and powerful anti-decay material will mean stronger, longer lasting fillings. If this technology is placed on the market, patients may be able to receive good looking, strong composite fillings with a protective level of anti-decay agent. Due to more durable fillings, patients may be able to visit the dentist less to repair failed ones. Less visits to your dentist office may allow you cheap dental bills long-term. Although this new technology is not yet widely available, be on the lookout. If you have questions about the availability of nanocomposite fillings, you may want to check with your local dentists see when this new technology will be introduced to their offices.

Durable Nanocomposite Filling Improvements May Better Prevent Decay For Long-Term Cheap Dental Care

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