2008 Annual Report
What is Group Health doing to stem the rising costs of health care and insurance premiums?
Michael Soman, MD: Group Health is implementing a new way of providing primary care in all 26 of our medical centers. We believe this approach will better serve our patients, bring our costs down, and help reduce premium trends — even while improving quality. We tested this "medical home" model in our Factoria Medical Center for two years and intensively studied its effects. There are hefty up-front costs, partly because it adds more doctors. However, even with a $1.2 million investment over two years, the pilot paid for itself, in part by decreasing ER and hospital use.
By giving patients 24/7 access to their physician and health care team — not just face-to-face but also via phone visits, secure e-mails, and proactive reminder letters — people got healthier. Customer satisfaction went up, quality went up, even job satisfaction among doctors, nurses, and staff went up. But the total cost didn't go up. We're convinced that this enhanced approach to primary care will not only lower costs but also motivate more and more people to join Group Health, and that, too, will help bring our cost trends down.
What's more, the Group Health Center for Health Studies is part of a five-year initiative to help 50 safety-net clinics across the country adopt the medical home model. The project is funded by The Commonwealth Fund, an independent national foundation working for health reform.
James Hereford: For business customers, we've developed a set of reporting tools to help maximize the value of their health care investment. We team with employers to gather information about their workforce and then design strategies to improve the health of their employees. The approaches we choose are tailored to the customer. Maybe it's a wellness program. Or more preventive care. Or counseling to help staff members with chronic diseases better manage their conditions. The benefits are obvious. Healthier employees miss fewer work days, stay more engaged with their jobs, and make businesses more competitive. We're jazzed about these tools because they create a much more productive relationship between Group Health and our purchasers.
Brenda Bruns, MD: Financial incentives must shift to support prevention and to focus on providing the most appropriate and effective care. Doing unnecessary back surgery — when current medical research shows that physical therapy could solve the problem — is less likely to happen under that scenario. Until the marketplace stops rewarding doctors and hospitals for doing more and more of everything, paying for quantity not quality, health care costs will definitely remain out of control.
Scott Armstrong: It's all about the incentives. I think the country is finally realizing you can't solve the health care crisis unless you do the kind of thing that Group Health does. Our model discourages overtreating or denying coverage, because the incentive is to do only what's best for the patient, not what makes margin. So you end up with what everyone says they want — the best quality care without insurance company hassles and without doctors and hospitals seeing each patient as a profit center.
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