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Study finds how U.S. health care system can reduce spending by up to $300 billion

by Lauren Dubinsky, Senior Reporter | December 08, 2014
Jeffrey Selberg
Stanford University's Clinical Excellence Research Center (CERC) conducted a study that looked at 15,000 primary care practices in the U.S. and found that fewer than 5 percent were in the top quartile for quality of care and at the bottom for total health care spending. The study was funded with a grant from the Peterson Center on Health Care.

The researchers pooled together single- and multi-specialty primary care practices in the U.S. with at least two physicians. They then used quality measures mostly sourced from Health Effectiveness Data and Information Set (HEDIS), which is used by more than 90 percent of U.S. insurance companies to evaluate quality.

They discovered that fewer than 5 percent of the facilities ranked in the top quartile for quality and the bottom quartile for costs. After that discovery, the next step they took was to determine what unique characteristics those practices possess.

The researchers chose 11 practices and conducted a series of in-depth site visits, and found that the total annual health care spending was 58 percent lower for patients cared for in those practices compared to patients cared for in other practices. They concluded that if every practice adopted the characteristics the top practices have, the change has the potential to improve quality and bring down annual health care spending by up to $300 billion.

"Our feeling is that this is something very worth replicating and facilitating the adoption of across the country in primary care," Jeffrey Selberg, executive director of the Peterson Center on Healthcare, told DOTmed News. "Another reason we think it's so important is that not only do the patients seem to be more satisfied, but the physicians and the staff that support them are more satisfied with their professional environment."

The characteristics that the top practices possess are that they are always accessible to their patients, they do as many tests as they can safely perform in-house, they follow-up with their patients, maximize the abilities of their staff, prioritize their staff over space, equipment and technology, facilitate physicians' supervision and communication across clinical teams, balance physicians' compensation, the physicians choose tests and treatments wisely and patient complaints are used to improve the patient experience.

Some of the top practices include Banner Health Clinic Internal Medicine in Arizona, Family Physicians Group in Florida, Ridgewood Med-Peds in New York, St. Judge Heritage Medical Group in California and TriHealth West Chester Medical Group in Ohio.

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