Volume XXVll, No. 5
August 2013
The Independent Medical Business Newspaper
Chronic illness and patient satisfaction Examining the links between them By Caroline S. Carlin, PhD, Jon B. Christianson, PhD, and Michael Finch, PhD
I
t has been more than a decade since the Institute of Medicine’s “Crossing the Quality Chasm” identified patient satisfaction as a component of quality in health care, and interest in improving patient satisfaction has been growing ever since. Comparative reports of provider quality increasingly include patient satisfaction measures, and services such as Angie’s List and HealthGrades report consumer ratings of health care providers accompanied by consumer comments. Patient satisfaction scores also have been used in computing pay-for-performance (P4P) bonuses and in constructing “tiered” benefit designs that encourage consumers to seek care from higherranking providers. SPECIAL FOCUS: Because improving Physician care for patients with Reimbursement chronic illnesses is a Page 20 primary focus for P4P plans and public reporting, an under-
When less is more
ILLNESS to page 12
LESS IS MORE to page 10
PAID
T
he overuse of health care services is a significant contributor to rising health care costs in the United States. While some health care utilization is driven by changing demographics, the Institute of Medicine estimates that as much as 30 percent of health care spending is wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Also referred to as clinical waste, unnecessary services is the largest factor in this type of wasteful spending. Clinical waste is estimated to have accounted for $5.8 billion of the $37.7
PRSRT STD U.S. POSTAGE
By Tim Hernandez, MD, Kris Soegaard, and Howard Epstein, MD, FHM
billion spent on health care services in Minnesota in 2010. Unfortunately, more care does not necessarily equate with better care, and may actually be harmful. Two examples are nuclear imaging for coronary disease and the general use of CT scans. Both procedures are associated with significant radiation exposure. In fact, many experts agree that patients are exposed to excess radiation through procedures like non-indicated CT scans and nuclear imaging with stress test. In a study of CT scans in the emergency room published in Emergency
Detriot Lakes, MN Permit No. 2655
The issue of clinical waste