Low cost and high quality aren’t enemies
By Karen Jorge
I had a doctor’s appointment the other day. While making small talk as he looked through my records, the doctor asked me what I do for a living. After I told him that I work in hospital performance improvement, he said that he was very concerned about healthcare reform, because it made everyone think that they had to provide an “impossible” combination of high-quality and low-cost care, with too much of an emphasis on cutting costs.
While this particular physician may have been correct that only focusing on cutting costs won’t improve care, he missed the point. High-quality care doesn’t have to cost more. It is in fact very possible to inexpensively provide high-quality care precisely because providing such care lowers its delivery costs. Poor quality is much more expensive, as it requires extra resources to fix problems, and results in longer lengths of stay and higher malpractice costs.
HMC has found that hospitals that provide the highest quality care are usually some of the lowest-cost performers. Driving organizational change through quality-improvement initiatives can ultimately lower hospital costs by avoiding expensive off-quality events, lowering length of stay, and making care more efficient. As an added bonus, approaching hospital performance improvement in this vein can be more valuable and palatable to physicians – who are primarily (and understandably!) concerned with providing the best possible care. It also can facilitate getting them on board with strategic improvement projects.
The relationship between cost and quality doesn’t have to be an antagonistic one that makes a hospital try to determine just how much money it can cut from the budget before quality suffers. Instead, by “leading with quality,” the cost drops will follow.
Karen Jorge is an HMC analyst.
