Better H health care, lower cost The state’s Payment Improvement Initiative shows it can be done. BY LESLIE NEWELL PEACOCK
12
APRIL 3, 2014
ARKANSAS TIMES
ere was a question a team of public and private insurers and health care specialists put to doctors who perform tonsillectomies: After surgery, do you send the tonsils to pathology for a full stain and thin-slice workup? Or just for a gross inspection? Or do you simply pitch the tonsils in the nearest biohazard bin? Here’s the best answer for slowing medical costs while providing quality care, the goal of the Payment Improvement Initiative’s public and private partners: Pitch them. In virtually every case, doctors suspect before they operate whether the tonsils they are removing are malignant and need to go to pathology; otherwise, the pathology study is deemed unnecessary. That means savings at no cost to a patient’s health. The initiative of the state Department of Health’s Medicaid division and private insurers Blue Cross Blue Shield and QualChoice, launched in 2011, given a trial run in 2012 and now in place, is showing that when doctors know the full costs of treatment of, for example, hip and knee surgery, they may change their practice behavior, creating savings in total health care dollars spent.