What Are a Hospital’s Costs? Utah System Is Trying to Learn
By GINA KOLATA
SEPT. 7, 2015
nytimes.com
SALT LAKE CITY — Only in the world of medicine would Dr. Vivian Lee’s question have seemed radical. She wanted to know: What do the goods and services provided by the hospital system where she is chief executive actually cost?
Most businesses know the cost of everything that goes into producing what they sell — essential information for setting prices. Medicine is different. Hospitals know what they are paid by insurers, but it bears little relationship to their costs.
No one on Dr. Lee’s staff at the University of Utah Health Care could say what a minute in an M.R.I. machine or an hour in the operating room actually costs. They chuckled when she asked.
But now, thanks to a project Dr. Lee set in motion after that initial query several years ago, the hospital is getting answers, information that is not only saving money but also improving care.
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Recently, Dr. Porter and a colleague, Robert Kaplan, visited Utah and concluded that the hospital group was one of the few in health care to properly measure the costs of care. Elsewhere, with a very few exceptions, Dr. Porter said, “it’s a total mess.”
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Some were skeptical the program would make a difference, Dr. Bull said. But costs fell by 30 percent because patients spent less time in the hospital and had fewer complications. Letting nurses initiate treatment meant patients got needed medications faster, and the emphasis on “perfect care” meant the most important things got done.
“When I first started working in health care, like everybody I thought: ‘Oh, my God. It’s such a tough problem,’ ” Dr. Porter, the Harvard economist, said.
Now he has changed his mind. “I have no doubt we can solve it,” he said. “We know exactly what we have to do.”........ |
