Center for Studying Health System Change

Quality Efforts Expand as Seattle Health Plan Products Evolve

Employers and Health Plans Pursue New Strategies to Influence Quality and Efficiency

News Release
Sept. 27, 2005

FURTHER INFORMATION, CONTACT:
Alwyn Cassil (202) 264-3484 or acassil@hschange.org

WASHINGTON, DC—In an effort to control health care costs and improve the quality of care, Seattle employers and health plans are pursuing new strategies to directly influence provider quality and efficiency, according to a new Community Report released today by the Center for Studying Health System Change (HSC).

Within the next few years, health plans expect to implement pay-for-performance programs that provide higher payments to higher-quality and more efficient physicians. However, given the history of contentious contract negotiations, health plans are proceeding cautiously and developing measures collaboratively with physicians.

"Health plans are developing new products and provider performance measures in hopes of slowing health care cost growth and improving health care quality," said Paul B. Ginsburg, Ph.D., president of HSC, a nonpartisan policy research organization funded principally by The Robert Wood Johnson Foundation.

At the same time, hospital systems have added capacity and expanded particularly profitable services, such as cardiac care, while facing increased competition from physician-owned facilities for outpatient services.

Other key findings of the report, Community Quality Efforts Expand as Seattle Health Plan Products Evolve, which is available here, include:

• Hospitals and large physician practices have continued an internal focus on quality improvement and are investing heavily in information technology.
• Access to physician services for low-income and uninsured people has deteriorated.
• Despite an expected $1.7 billion deficit, the state has committed to maintaining health programs, including the restoration of lost federal Medicaid funds for mental health services.

Seattle is one of 12 communities across the country tracked intensively by HSC researchers through site visits. The new report is based on a March 2005 site visit and interviews with more than 100 Seattle health care leaders, representing health plans, employers, hospitals, physicians and policy makers.

The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nation’s changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by The Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.