PALMYRA, Maine — Mainers who use high-quality doctors and hospitals are more likely to be satisfied with the care they get, and their employers are more likely to have healthy workers to show for their investment in health insurance, a health quality expert told local business leaders Friday.
As it becomes easier to find and compare local health care quality information on the Internet, businesses should encourage employees to seek the best providers available, said the expert, Ted Rooney, a consultant with the nonprofit Maine Health Management Coalition.
During a breakfast meeting at the Millennium Conference Center, about 20 Newport-area business leaders and health care providers learned more about the availability of online health quality information and the bottom-line concerns driving it. The event was sponsored by Eastern Maine Healthcare Systems of Bangor and the Sebasticook Valley Chamber of Commerce.
Rooney, the keynote speaker, told meeting participants that health care is unique in the unquestioning way it is typically purchased.
“How many of you know the value of the health care services you purchase?” Rooney asked the audience. “Is that how you run your business in other areas? Do you just take what your vendors offer?”
Rooney said employers who provide health care coverage should negotiate with insurance companies to provide incentives, such as lower co-payments, for employees who use high-quality providers.
According to its Web site, the Augusta-based Maine Health Management Coalition is a partnership among self-insured employers, insurance companies, hospitals and physician practices aimed at improving the value of health care.
Rooney introduced the growing amount of Maine-specific data available on the Maine Health Management Coalition’s Web site, which compares primary care physician practices, pediatric practices and hospitals in specific clinical and patient satisfaction areas.
The information on the site is distilled from state and national reports and vetted by a 14-member steering committee. Rooney said some patients seek more detailed information than is posted on the Maine Health Management Coalition site, but others want only a simple apples-to-apples look at how area providers measure up.
Dr. Erik Steele, vice president and chief medical officer at EMHS, said health care organizations are under growing pressure to improve the quality of the care they deliver. For one thing, he said, hospitals lose consumer confidence when patients develop complications or receive less than optimal care. Second, the federal Medicare program and most private insurers recently stopped paying for extended care related to preventable errors. Third, Steele said, the expanding use of standardized treatment protocols means that those who don’t follow them may become easy targets for allegations of malpractice.
Steele said the trend for shopping for high-value health care is driven by people who have either no insurance or high-deductible plans and must pay much or all of the cost of their care out of pocket.
Because Medicare and Medicaid pay poorly compared to private payers or commercial insurance policies, the comparison-shopping practice is stimulating competition among hospitals for “high-end” patients, Steele said.
“You care if your Anthem patient who needs a hip replacement goes to Portland instead of Sebasticook Valley Hospital [in Pittsfield],” Steele said. But improved performance benefits all patients, he noted.
Steele stressed that it is not enough to simply educate doctors about advances in medical care. For example, he said, it has been well-documented for more than 20 years that a class of drugs known as beta blockers helps prevent repeat heart attacks in patients who have suffered one attack. Yet in the absence of mandated change, “It has taken us 20 years to get to the point where we’re delivering beta blockers to 80 percent of the patients who should have them,” Steele said, referring to the medical profession as a whole.
New practices based on scientific evidence must be reinforced by using technology to prevent errors and oversights, Steele said.
The presentation in Palmyra was the second of four such events being held in the EMHS service area. The first was in Brewer on Oct. 2. Future presentations will take place on Nov. 7 in Presque Isle and on Nov. 14 in Waterville.
The Maine Health Management Coalition’s health care quality data can be found at www.mhmc.info.