Health

22 HEALTH • Summer 2018 T he cost of medical services is a hotly debated topic in congress, in state houses, in board rooms, and in living rooms everywhere. Focusing on the cost of something as critical as health care may feel unseemly to many; but cost matters, especially in this age of high-deduct- ible health plans, exorbitantly expen- sive pharmaceuticals, and state bud- gets straining under the weight of ris- ing healthcare spending. In 2018, Medicaid alone comprises nearly 30 percent of our state bud- get. Nationally, healthcare spending is expected to account for nearly 20 percent of the gross deomstic product by 2025. e rise in healthcare spending is unsustainable and drains other essential services. And we know that higher-cost care very oen does not result in better outcomes. e Massachusetts Health Policy Commission – an independent state agency charged with monitor- ing health care spending growth in Massachusetts – recently published a report that showed stunning variation in the cost of services provided in 14 large Massachusetts health systems. e commission reported that the highest-cost system spends 32 percent more per patient than the lowest-cost system. In hospital outpatient spend- ing alone, the highest-cost organi- zation is twice as expensive as the lowest-cost group. Multiple factors were cited as driving this cost variation, including price-per-service, utilization rates, patient income levels, and "practice patterns and culture", which refers to the clinical culture within a health system that influences care delivery. In nearly every cut of the data, the HPC found that Reliant Medical Group provides care at a lower cost. In isolation, this distinction is not all that meaningful and could be misinter- preted by those who perceive lower- cost care to mean lesser care. is is why I am most proud that Reliant also consistently exceeds national standards in the 30 health- care quality measures defined by the National Committee for Quality Assurance. In fact, we rank in the 90th percentile in most national quality measures. In patient satisfaction, we typically perform better nationally than 80 percent of groups like us. We do this while more efficiently man- aging costs for patients, employers, insurers, and our state and federal governments. At Reliant, we believe that manag- ing both the quality and the cost of care is, indeed, about efficiency; but it is also about being socially and clini- cally responsible. Our clinical culture is based on the premise that providing evidence-based, proactive ambulatory care is the best way to keep patients healthy and out of high-cost health- care settings. We avoid duplicative or unnecessary medical testing, which drive up costs and provide no clinical benefit to patients. We assertively manage chronic conditions, like diabetes and heart disease. We optimize our electronic medical record so that everyone on the treatment team has access to a patient's information. And we try to provide as many medical services as possible within our system to avoid the occurrence of fragmented, unco- ordinated care. In healthcare, quality is job one; but everyone in healthcare needs to be concerned about the cost of care. Caregivers should rigorously pursue clinical excellence, while always being mindful that we are stewards of limited healthcare resources. As a physician, what I want for my patients, my loved ones, and myself is excellent healthcare delivered at the lowest cost possible. While thinking about cost in the context of medical care can be un- comfortable, the inescapable truth is that all of us experience real health- care value when high-quality care is coupled with the efficient and respon- sible management of costs. Providing and demanding valued-driven care is our collective responsibility and the only way we will be successful in curb- ing rampant healthcare spending. Tarek Elsawy is the president and CEO of Reliant Medical Group. More Than Just 'General Surgery' Stephen Hilborn, MD Thomas Johnson, MD Evan Provisor, MD Colette Whitby, MD • Cancer Cell Excision • Mastectomy (coordination with Plastic Surgery for reconstruction) • Port Placement for IV Treatment • Oophorectomy (Ovariectomy) with BRCA2 Positive 100 South St., Suite 108 Southbridge MA 01550 (508) 764-6966 harringtonhospital.org Additional surgical services include gallbladder removal, hernia repair, appendectomies, chest/thoracic bowel resections and more. Quality is the top priority, but affordability is right behind CONSUMER ADVICE By Tarek Elsawy, MD H

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