Partnering to provide quality care based on medical evidence
(April 1, 2011)
Priority Health is committed to partnering with physicians to provide accountable care that optimizes clinical outcomes and ensures the best care experience while eliminating avoidable costs. This includes a series of initiatives that focus on pursuing the best practices through enhanced transparency and comparative effectiveness. Examples include:
- Reducing geographical variations in procedure frequency
- Ensuring medical appropriateness of procedures
- Improving members’ awareness of treatment options
Our approach will include: member education, benefit design, shared-decision-making tools for elective surgery, prior authorizations and reimbursement mechanisms.
Part of a national trend
A 2008 article from the New England Healthcare Institute, "Waste and Inefficiency in the US Healthcare System," concluded:
"There is a compelling need to address waste in healthcare for three reasons. First, the cost savings associated with eliminating waste are likely to be very large. Second, collaborative efforts to control waste could spur an emphasis on evidence based practice that could lead to long term quality improvement. Third, beyond economic arguments, wasteful spending may actually decrease the quality of health care. Unnecessary procedures and medicines, for example, expose the population to significant health risks, complications and even death. In addition, waste associated with failure to follow accepted treatment protocols not only costs money, but decreases productivity, reduces quality of life and may cause death."
