ACC Vice President Ralph Brindis, M.D., F.A.C.C., kicked off this morning’s first session on defining quality and value at the 2009 Health System Reform Summit. The speakers – Douglas Wood, M.D., F.A.C.C., of Mayo Clinic, Glenn Steele, president and CEO of Geisinger Health System, and Francois de Brantes, CEO of Bridges to Excellence – all agreed that we need to seek value, and by pursuing quality we will get toward the ability to reduce costs. This is the opposite of the discussions in the political world – where the #1 priority is reducing costs, followed by quality.

Wood and de Brantes agreed that value is the best combination of quality and price. Wood argued for a formula for value, where: 

VALUE = QUALITY (Outcomes, Safety and Service)
            -------------------------------------------------------
            COST (Unit price X Use rate) 

By assigning numbers to these positions, you can determine the value of any given procedure, he said. This system has the potential to be implemented right away, and could be improved over time, according to Wood. Wood also made the point that quality should be the first focus of reform, and by improving quality, costs will be reduced over time.  

Steele talked about his Geisinger's efforts to improve care and reduce costs through chronic disease care optimization and acute episodic care; patient engagement; transitions of care; and the advanced medical home. For example, through its advanced medical home program (ProvenHealth Navigator), which uses partnerships between physicians (albeit mostly in larger practices and with health IT) and hospitals, Geisinger decreased medical costs by 4 percent and dropped readmission rates by 5 percent. Readmission rates for heart failure dropped by 40 percent. 

The bottom line: Efforts like this need to continue so we can brainstorm better ways of providing care. Value in care is not discussed nearly enough. If we are going to reform the health care system, the combination of quality and price MUST be part of the discussion, if not the whole discussion. The ACC knows that – increasing patient value is the #1 principle of ACC’s health care reform campaign and the #1 purpose of the application of registries, in particular the IC3 quality efforts  ... and the value principle was crafted LAST year at the 2008 Health System Reform Summit. Let’s hope value in care moves to the forefront in future discussions on reform.