2004 Economic Issues Forum
Quality of Care and Cost-Effectiveness
Keynote speakers for the 2004 ACR Annual Meeting and Chapter Leadership Conference, "Quality Issues in Health Care," were Arnold Milstein MD, MPH, co-founder of the Leapfrog Group and the Consumer-Purchaser Disclosure Project, and Reed Tuckson, MD, senior vice president for UnitedHealth Group. These nationally renowned speakers provided the council with two different perspectives on health care quality and costs as they relate to radiology and radiation oncology and discussed how in the future health care purchasing and reimbursement will center on superior cost efficiency and quality.
Tuckson spoke from the payer's perspective, reviewing his efforts to provide the highest quality health care and access to the latest technology while facing the challenge of rising health care costs. He stated in the future health care will have a different face: Consumers are being encouraged to be more involved in their health care decisions, which could change the way health plans provide medical coverage. UnitedHealth also strives to work more closely with the medical specialties to investigate how new technologies, such as molecular imaging, can be incorporated into health plan coverage while still achieving cost efficiencies as health care costs continue to rise.
Milstein gave an employer's perspective, pointing out health care costs are the number one concern among the Fortune 500 CEOs. Increased scrutiny of health care providers leads to the establishment of new reimbursement methodologies such as pay for performance and additional emphasis on health care consumerism. He stated there is a need for performance and outcome measurement of physicians, other health care providers, and suppliers to achieve continuous quality improvement and accountability. Milstein outlined evolutionary steps involving performance disclosure and comparison, improved sensitivity to physician and hospital performance, and clinical reengineering, which would ultimately result in improved quality and decreased costs. The concepts and steps presented paralleled information presented by the Institute of Medicine in its report Crossing the Quality Chasm.
Medicine is in the midst of a changing health care industry with a focus on performance measurement, outcomes measurement, quality improvement, and cost efficiency. Irrespective of individual positions and opinions, the College must remain at the forefront of these discussions to ensure radiology and radiation oncology are appropriately represented and heard as purchasers and health plans alike move toward pay-for-performance methodologies.