Visiting the site of the 90's Health Car Wars

I had previously blogged about how some of the bloodier health care wars in the 90's did not take place in Washington DC. For example, the health care wars in Southern Oregon resulted in a community with medical costs that are 50% higher than most of the state and utilization so high that the amount of cataract surgeries performed exceeds the number of eyes in the counties.

I visited one of the hospitals in Southern Oregon this week. As you can see from the picture on the left, it's still the wild west. They're just as mad about the Indian Wars of the 1850's as they are about the health care wars of the 90's. Actually, I'm kidding. The picture is from a historical mining town called Jacksonville but some are still mad about the Indian Wars.

The day was a tale of two meetings. The hospital that I visited is part of our health system and we have a history of working together. The discussion was very objective as we focused on what were the advantages of bringing our health plan to the region. The hospital CEO noted that patient and provider satisfaction scores were higher in areas where the hospital and health plan were active. This at least demonstrated that the health plan did not distract from satisfaction. We also discussed integration opportunities and how to work together to reduce health care costs and improve quality.

We also discussed opportunities to grow market share. However, an insurance plan that just included the one hospital would not be appealing unless it would be a significantly lower cost plan. Our greatest opportunity was improving health care efficiency not using market forces.

This was a stark contrast with the conversation from the other hospital. I was not there but I was told that they saw no immediate need to lower their reimbursement nor reduce utilization of discretionary procedures. There were still more cataract surgeries to be done. While this hospital acknowledged that change was likely to arrive and their practice was not sustainable, there was no burning platform to reduce health care costs or change practice patterns.

One meeting showed the immense possibilities when the providers and health plans share a common vision. The ability to talk as partners is a foundation for change.

The other meeting showed how far away that change could be and the immense inefficiencies that can are created when a health plan and hospital do not share a common vision. And by inefficiencies, I really mean clusterf#ck but I'm trying to sound scholarly.

Final result of the visit is that I am now just as angry about the 1850's Indian Wars! Southern Oregon is starting to rub off one me. I really enjoyed the town of Jacksonville. This town of 2400 has an amazing music festival with a line-up that includes Blues Traveler, Wilco, orchestras, Ani DiFranco, and some great acts!