Health care is supply-sensitive, meaning where there is greater capacity, more care is delivered, regardless of need. Primary care is an essential driver of quality health care, but in the U.S., it is the most neglected.
Most experts agree improving health care quality is attainable and necessary; it rests on a delicate balance of efficient allocation of limited resources and patient-centered care.
Health care quality is the first pillar of five comprising this high-level plan to transform the health care system to deliver higher-quality care, value to patients and improve the health of Florida residents. (See the intro article in this series: Florida Blue’s five pillars for transforming health care.
Not just a litany of ills, Blueprint for a Healthier Florida 2013 proposes five health care quality solutions:
- Compare the quality and cost of new health care products and services with those already on the market so consumers can make informed decisions.
- Provide sufficient funding for the establishment of a viable health information network to reduce unnecessary medical errors and provide evidence-based care.
- Continue efforts to explore alternatives to fee-for-service payment models, such as patient-centered medical homes (PCMHs) and accountable care organizations (ACOs) that will emphasize quality over quantity.
- Promote the implementation of primary care models that evidence has shown to improve quality and lower costs through greater coordination among providers.
- Initiate robust efforts to address health care disparities and health literacy.
Florida Blue is walking the health care quality talk through its leadership in implementing PCMHs and ACOs. Approximately 30 percent of our medical spend is through value-based models, including PCMHs and ACOs. With over 2,200 primary care physicians and 240 participating groups, Florida Blue has one of the largest PCMH programs in the nation.
We also have seven ACO-type agreements, with more in the pipeline. Under our PCMH program, physicians have performed the same or better than non-participating peers in all of the 29 clinical quality metrics. Emergency room visits have dropped by 12 percent, and overall Florida Blue has seen cost reductions of four percent or higher during the first year of implementation.
We’ll be covering each of the remaining four pillars and Florida Blue’s proposed solutions in future articles. We invite you to engage in conversation with the leaders of our health policy team, Jason Altmire, Senior Vice President of Public Policy, Government and Community Affairs at Florida Blue on Twitter @jasonaltmire, and Carl Patten, the director of the Florida Blue Center for Health Policy @carlwpattenjr.