The nonprofit Network of Regional Healthcare Improvement (NRHI) recently released a report, From Volume to Value: Transforming Health Care Payment and Delivery Systems to Improve Quality and Reduce Costs, that urges reforms that could save billions of dollars and make expanding health insurance to the uninsured more affordable.

According to NRHI, the high cost of health care expenditures – estimated to $2.2 trillion in 2007- is due in large part because health care payment systems encourage volume-driven health care rather than value-driven health care. Under the current volume-driven payment systems, health care providers have strong incentives to provide more services to more individuals, but are financially discouraged to provide better services and improve health outcomes.

NRHI recommends that payments move towards a value-driven system, where insurers pay health care providers a single amount that covers all the services a patient needs instead of separate fees for each services. Additionally, insurers should move from a system that pays more to correct errors and preventable complications to a system that rewards health care providers for successful health outcomes. NRHI argues that such a system shifts responsibility to health care providers to increase quality and control costs.
The report also addressed the following health care issues:

• Encourage patients to use higher-quality, lower-cost doctors;
• Protect patients from service rationing (providing patients with a fixed amount of health care services, regardless of need); and
• Help health care providers change to new payment systems and lower-cost care.

The Improve Group staff has worked with multiple clients regarding public health issues regarding improving health care quality and access. As a small business, we also feel the need to look for the best health care coverage at the best cost for our own company and its employees. In these turbulent economic times, for an increasingly aging and socioeconomically diverse society, finding solutions in improving the quality and access health care are becoming increasingly important. Thus, there are many opportunities for evaluation, research and strategic planning to address these important issues.