Quality Matters Newsletter

The New Vocabulary of Medicine (Winter 2012)

The changes we have seen in medicine in the last twenty years have been extraordinary, from the “routine use” of CAT scanning for things spanning the spectrum of serious (intracranial hemorrhage) to the symptomatic (chronic sinusitis); to entirely new classes of drugs such as Proton Pump Inhibitors (PPIs) for our gastroesophageal reflux disease and Statins for our abnormal lipid profiles. These and other advances have led to healthier patients, decreased complications and possibly better outcomes.
But all of these advances have come with a price and in this case it really is “the price”. We have seen health care expenditures in this country soar beyond anyone’s prediction from just a few short years ago. In addition, the trend for healthcare costs continues to rise, exceeding general inflation rate and virtually every other business cost that’s analyzed and reported.
So what does this all mean?

It means that the ability to fund current and new forms of treatment, procedures, imaging studies and care is in serious jeopardy unless we can find a way to “bend the trend” and begin to look at the cost of the care we provide. We need to look at the VALUE we bring to the patients in Health4, not just the quality, because without the means to support our care, quality will suffer regardless of our best efforts.
This means that we have to start to think about “Quality” and “Cost” in the same sentence, because their by product is “Value”, something the purchasers of healthcare are demanding.  We need to link Quality and Cost (Value) so we are all speaking the same language in this new environment.

The new vocabulary of medicine will contain terms such as Total Cost of Care, Attribution Logic, Attributable Members, Shared Savings, Per Member Per Month costs and Population Management. We will have to own these phrases and make them part of the “new vocabulary of medicine” as we enter into 2012 and beyond.

Health4 is our way of adapting and preparing for the new “Value vs. Volume” paradigm. Significant work has been done with our key payers in areas cited above (exp. Total Cost of Care) as we prepare to demonstrate that Health4 is the value provider of care in central Ohio.
Look for additional details about the Total Cost of Care model we are adopting in future communications from The Medical Group of Ohio. The healthcare environment is rapidly evolving into complex and challenging areas. We recognize this and welcome the opportunity to show our commitment and ability to provide real Value to our patients, providers, payers, employers and community.

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