Sunday, May 20, 2012

Hearing Held to Discuss DSR

Senator Sheldon Whitehouse (D-RI) chaired the May 16th hearing for the Health Education, Labor, and Pensions (HELP) Committee to discuss Delivery System Reform (DSR). The hearing titled “Identifying Opportunities for Health Care Delivery System Reform: Lessons from the Front Line” examined healthcare improvements already being achieved through DSR efforts, and highlighted the potential of these reforms to lower costs and improve care without cutting benefits.

The Senator identified five priority areas for reform efforts such as payment reform, primary and preventive care, measuring and reporting quality, administrative simplification, and health information technology.

Dr. Al Kurose, President and CEO of Coastal Medical in Rhode Island testifying at the hearing reports that Coastal is a physician governed medical group practice founded 17 years ago in Providence now employing 91 providers and providing primary care to 105,000 patients in the state.

He discussed how experience with SCI-RI, a Multi-payer Advanced Primary Care Practice demonstration site taught the organization valuable lessons about PCMH implementation. The Medicare Shared Savings ACO and Advanced Payment Model program have also proved to be important drivers to help Coastal embrace accountable care. According to Kurose, applications to these programs are pending and Coastal is hoping to be approved for a July 1 start date. 

He explained how DSR efforts have helped lower costs in the organization. “We have committed ourselves to reduce the total cost of care for our populations of patients by 5 percent by the end of 2012,” said Dr. Kurose. “Already, we can point to significant accomplishments in our efforts to reduce costs, but most of our potential has yet to be realized.”

Kurose also noted the improvements in patient services implemented by Coastal. He reports that every phone call is now answered “Hello Coastal Medical. Would you like to see a provider today?” Coastal Medical recently initiated the ‘Coastal 365” campaign to let their patients know that an office will be open where they can see a primary care physician 365 days a year.

Another witness testifying was Marcia James, Director of Provider Engagement for Human, Inc. She spoke about some of the specific DSR efforts Humana has worked on, including a pilot program with Norton Healthcare System in Kentucky that stresses accountability of measured outcomes, cost, and patient delivery.

As James told the Committee, “Already, the partnership has shown significant results with a 9.1 percent decrease in unnecessary antibiotic treatment for adults with bronchitis, a 6.1 percent improvement for diabetic testing, and 8.6 percent improvement for cholesterol management in diabetics.”