Medical outcomes vary too much for every doctor or surgeon to be able to claim they're doing the best job.
That idea was one of the premises behind a recent study of bowel surgery data by a team at UnitedHealthcare, says Dr. Ed Dasso, the company's medical director for clinical improvement and analytics.
The company sifted through health care claim data from its network and looked at how outcomes varied for surgeons in similar cases, markets, and specialties. Where it found a wide spectrum of results, it took a closer look at what factors or decisions, such as length of hospitalization, were most often associated with a quick and complete recovery for the patient.
The result was a set of data and a list of evidence-based best practices for preventing bowel surgery complications, both of which UnitedHealthcare shared with gastrointestinal surgeons.
"The approach we took here was no penalties, no promises. We just did a good-faith effort of sharing information with these surgeons," says Dasso. "We said, 'Here are your results compared to your peers'... and then, 'by the way, if you are interested, here are the most current evidence-based treatment guidelines that could help reduce that variance. What you choose to do with that information is totally up to you.'"
"That was one of the premises we wanted to test with this: is just the sharing of this type of information going to result in some sort of action and potentially impact practice patterns? And, fortunately, it did."
Over the next 18 months, the health insurer observed a 50 percent decrease in avoidable hospital days and a decrease in surgery-related readmissions. The changes also produced inpatient cost savings of approximately $7.4 million during that time period. Dasso says cost savings wasn't the motivation, but that they're learning that better care and reduced costs often come hand-in-hand.
The work recently earned the company
an innovation and leadership in health care award from Milliman Care Guidelines, a company that develops evidence-based clinical guidelines.
Source: Ed Dasso, UnitedHealthcare
Writer:
Dan Haugen