Harvard Pilgrim’s efforts to redirect patients to lower cost diagnostic tests (Boston Globe, December 20) can be a first step in having healthcare sourcing decisions made based on quality and cost. This depends on the insurer’s recommendations reflecting both quality of care and cost data.  On the other hand, merely rewarding providers who have negotiated favorable bulk purchase contracts would benefit the payer but not the patient too.

The reason this is helpful is that there are enormous disparities among providers.  Some are high quality and lower cost while others are more expensive but far less reliable, with jeopardy to patients’ wellbeing.  Ideally, patients would make informed choice when seeking care, thereby rewarding the excellent and penalizing the laggards.  Society’s overall capacity to provide care would be magnified while the cost would be cut substantially.

The handicap is that patients normally cannot make informed choices based on quality and cost data.  For example, finding it impossible to know where better care was available, I once picked an emergency department for my daughter’s playground injury based on the next-door coffee shop.  It would have been far better to have informed guidance in an important decision.  I hope Harvard Pilgrim’s initiative leads in that direction.

Related posts:

1. Paul Krugman: “Patients aren’t consumers” (but they should be)
2. David Brooks: “Where Wisdom Lives” way overstates Medicare problem…
3. Performance data and informed choice: Essential for moving from zero sum to net gain in heatlhcare reform…
4. Factory Efficiency Comes to Hospitals…NY Times July 11, 2010
5. Theory and Evidence for Repairing Health Care Markets So Markets Can Repair Health Care Delivery…