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Lessons From Abroad:

Lessons From Abroad:. International Efforts to Improve Quality, Reduce Costs and Increase Transparency. Robert S. Galvin, MD Bipartisan Congressional Health Policy Conference January 13, 2007. Lessons From Abroad. Where The U.S. Is Different Much Larger, More Heterogeneous Population

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Lessons From Abroad:

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  1. Lessons From Abroad: International Efforts to Improve Quality, Reduce Costs and Increase Transparency Robert S. Galvin, MD Bipartisan Congressional Health Policy Conference January 13, 2007

  2. Lessons From Abroad • Where The U.S. Is Different • Much Larger, More Heterogeneous Population • Health System Much Less Centralized…By Design(?) • - Federal vs. State vs. Private Sector • No Consensus On How To Control Costs • Very Medical Innovation-Technology “Friendly” • Where The U.S. Is Most Similar • Common Belief: Driving Value vs. Cost Containment

  3. U.S. Has Been Improving Quality…Slowly

  4. Purpose Goals Results (Performance) PATHWAY #1 PATHWAY #2 Improvement Selection + Payment Consumers Purchasers Patients Motivation Professional Organizations Care Delivery Teams Strategic Framework Board - 2003

  5. The Power Of Transparency Death Rate (RAMR) Hospital Columbia Presbyterian 3.93* Lenox Hill 2.26 NYU Hospitals Center 1.95 Weil Cornell – NYP 0.95* Surgeon RAMR State Total 2.25 Smith, C 4.15

  6. Payment and Improvement Institute of Medicine (2001) MedPAC 2004 (2004) “Purchasers should…Remove Barriers that…Impede Quality Improvement And Build In Stronger Incentives For Quality Enhancement” “Current Payment Systems . . . Are at Best Neutral and at Worst Negative Towards Quality” Glen Hackbarth “If I keep getting better, Dr Galvin, I’m going to improve myself right out of business”

  7. Health Costs: Lots of Opportunity, Little Focus Immutable & Desirable Ageing Technology Unhealthy Lifestyles Malpractice End of Life Care Cultural Uninsured Administrative Costs High Prices/Specialist Incomes Waste and Quality Shortfalls Lack of Accountability/Transparency System of Care

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