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Lessons From Abroad in Healthcare: Enhancing Quality and Reducing Costs

Explore international efforts to improve healthcare quality, reduce costs, and boost transparency, highlighting key pathways, challenges, and strategies. Learn from successful models and thought-provoking insights to drive positive change in the U.S. healthcare system.

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Lessons From Abroad in Healthcare: Enhancing Quality and Reducing Costs

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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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