Estimates vary, but several assessments concluded that at least 30 percent of our nation’s health expenditures—roughly $750 billion—do not improve health.13 We believe that the type of system-level improvements outlined in the Checklist hold the key to capturing this lost value. It is difficult to attribute dollars saved to the various items in the Checklist, because each is interrelated and, as discussed, some are fundamental enablers of more targeted strategies. However, when taken as part of a broad strategy to improve quality, our experiences have yielded promising results. To help give a sense of the possible yield of operationalizing a commitment to high-value care, displayed below are selected examples of better care and lower costs achieved within each of our institutions. If these results could be scaled nationally, the effect would be truly transformational.
|LIVESSAVED||67% decrease in elective CABG mortality at Geisinger||HIV mortality rate half the national average at Kaiser Permanente||Up to 200 lives saved at HCA from reduced CLABSIs|
|HEALTHGAINED||50% reduction in heart failure readmissions at Partners||∼60% reduction in ICU MRSA rates at VHA||∼20% reduction in admissions and readmissions for medical-home patients at Geisinger|
|PEOPLESATISFIED||95% percent of patients at ThedaCare’s Collaborative Care Unit rate it 5 out of 5||More than 90% satisfaction with Geisinger’s medical home||∼18% improvement in timeliness of care at the Virginia Mason IOCP program|
|THE RIGHTCARE||$10 million saved ($8,000 per patient) with Partners heart failure home monitoring||$17.5 million saved system-wide at HCA from decreased CLABSIs||$6.3 million saved from reduced surgical site infections at Cincinnati Children’s|
|AT REDUCEDCOST||7.1% reduction in total cost of care for medical-home patients at Geisinger||25% reduction in direct and indirect costs of patient care in ThedaCare Collaborative Care Unit||35% reduction in indirect cost of inpatient care for high-cost Medicare beneficiaries at Partners|
|EFFICIENTLYDELIVERED||$100 million in capital costs avoided at Cincinnati Children’s||$158 million in financial benefit at Denver Health since 2006||$200 million saved in 5 years through supply chain improvement at Intermountain|