Anyone who thought the only change coming to health care was in the federal law passed in 2009 hasn't been paying attention. For better or worse -- mainly, it looks to be for the better -- change is coming and some of it is taking shape in Western New York.
A new coalition of doctors, hospitals and insurers is looking to squeeze out some of the fat that drives up costs with few benefits to patients. The result, they say, will be a more efficient, patient-friendly system.
The proof, of course, will be in the paying, but it has long been clear that something had to happen to begin reducing the costs of health care, or at least to slow the rate of growth.
That, in fact, has been one of the urgent reasons for Washington to pursue health care reform, although it was a need largely unmet by the resulting legislation. Right here, though, BlueCross BlueShield of Western New York, Kaleida Health and a group of physicians are launching an effort to bend the cost curve and improve the quality of care.
The effort includes several approaches to those goals, but two of the primary ones are eliminating procedures that have been identified as unnecessary and decreasing the paperwork and sometime intrusive oversight of insurers. That effort is expected to free staff to pursue such critical work as better managing the care of patients with chronic conditions, such as diabetes.
Given the general acknowledgment that the costs of managing -- or more accurately, failing to manage -- such chronic conditions are a significant part of the problems of health care, that effort is crucial to any hope of controlling costs. So, for that matter, is preventing illness, another goal of the program, but one that will require the education and cooperation of health care consumers.
It's an important and interesting effort, but this coalition is not alone. At Independent Health, for example, the Patient Centered Medical Home project has improved disease management, while reducing use of emergency rooms and lowering overall costs. Univera, meanwhile, is using a carrot-and-stick approach that rewards clients for healthy lifestyle choices.
Many questions arise regarding these efforts, including labor issues within hospitals, how the savings will be shared with consumers and whether data on quality of care will be shared with the public, a strategy shown to help produce improvement in care. Still, these are promising developments in a critical part of the national interest. Besides being important to Americans who want to remain well, health care accounts for a huge portion of the economy -- nearly 20 percent of gross domestic product.
Americans pay more for health care than any other developed country, and for that they get only mediocre outcomes.
Clearly we have to do better. Efforts to integrate care an an important part of that goal.