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Health Care Industry Leaders Explore Ways to Define, Measure and Improve Efficiency

Health care system design creates winners and losers, making the problem difficult to solve.

Philadelphia, June 22, 2006
The ABIM Foundation today released summary findings from a roundtable, co-hosted by the Institute of Medicine, that brought together a diverse group of health care industry leaders to explore the issue of efficiency in health care – in particular, ways to reduce health care costs without sacrificing quality. More details of the discussion are provided in “Measuring and Improving Efficiency in Health Care,” available from the ABIM Foundation at www.abimfoundation.org.

Participants – physicians and other stakeholder leaders who share a commitment to advancing health care quality – agreed that our health care system is not efficient, and that strategies to eliminate waste from health care are needed to increase affordability and access. There was less agreement about whether and how that could be done. Consensus clearly emerged that physicians share the responsibility to work toward improving efficiency, that effective solutions will not emerge unless physicians are involved, and that physicians cannot focus narrowly on quality without considering the resources they expend.

Health care system creates winners and losers

The roundtable participants concluded that the structure of the U.S. health care system creates winners and losers. Medicine is practiced in an environment in which one sector’s cost is another sector’s revenue, and where one person usually loses something if another person gains. In that environment, there is no obvious way to improve efficiency without resistance from some group – typically a powerful one.

“Although no simple way exists to improve health care efficiency and eliminate waste, it is critical that all stakeholder groups continue this important dialogue,” said Christine Cassel, MD, President and CEO of the ABIM Foundation, who co-chaired the roundtable with Harvey V. Fineberg, MD, PhD, President of the Institute of Medicine. “Only through ongoing discussion can we achieve consensus and develop effective strategies to achieve greater efficiency in health care.”

A roadmap to improving efficiency

A few key elements in a possible solution strategy emerged from the discussion, including:

• Physician involvement, since doctors control the vast majority of health care resources
• Local leadership, because solutions will develop locally, not nationally
• Changes to the way that health care is paid
• Ongoing dialogue, so that there can be consensus about the complex issues involved

Potential strategies and solutions will be explored more thoroughly at the ABIM Foundation Forum, being held from July 29-August 1 in Colorado Springs, which is devoted entirely to the issue of optimizing efficiency in health care. The Forum, which promotes dialogue and decision-making, will include panel discussions with health care industry leaders from various stakeholder groups.

Roundtable participants included:

• Richard A. Baron, MD – Practicing internist and President, Greenhouse Internists, PC
• Bruce E. Bradley, MBA – Director of Health Plan Strategy and Public Policy, General Motors Corporation
• Troyen A. Brennan, MD, JD, MPH – Senior Vice President and Chief Medical Officer, Aetna Inc.
• Christine K. Cassel, MD – President and CEO, ABIM and ABIM Foundation
• Carolyn M. Clancy, MD – Director, Agency for Healthcare Research and Quality
• Robert Cunningham – Deputy Editor, Health Affairs
• Karen Davis, PhD – President and CEO, The Commonwealth Fund
• Harvey V. Fineberg, MD, PhD – President, Institute of Medicine
• Elliott S. Fisher MD, PhD – Director of Health Policy Research, Center for the Evaluative Clinical Studies, Dartmouth Medical School
• Alan M. Garber, MD, PhD – The Henry J. Kaiser Jr. Professor of Medicine, Primary Care Outcomes Research, Stanford University
• Paul Ginsburg, PhD – President, Center for Studying Health System Change
• Holly J. Humphrey, MD – Professor of Medicine and Dean for Medical Education, University of Chicago Pritzker School of Medicine and The University of Chicago Hospitals
• Karen Ignagni – President and CEO, America's Health Insurance Plans
• George I. Isham MD, MS – Medical Director and Chief Health Officer, HealthPartners Inc.
• Mark A. Kelley, MD – CEO, Henry Ford Medical Group, CMO and EVP, Henry Ford Health System
• Elizabeth McGlynn, PhD – Associate Director, RAND Health, Director of the Center for Research on Quality in Health Care
• James L. Naughton, MD – Associate Clinical Professor of Medicine, University of California, San Francisco and Chair, ABIM Foundation Board of Trustees
• Nancy Nielsen, MD, PhD – Speaker, House of Delegates, American Medical Association
• Margaret E. O’Kane – President and CEO, National Committee for Quality Assurance
• John Popovich, Jr., MD – Chair, Department of Medicine, Henry Ford Health System
• Robert D. Reischauer, PhD – President, The Urban Institute
• John W. Rowe, MD – Executive Chairman, Aetna, Inc.
• Leonard D. Schaeffer – Retired, Founding Chairman & CEO, WellPoint
• Stephen C. Schoenbaum, MD, MPh – Senior Vice President, The Commonwealth Fund
• Cary Sennett, MD, PhD – SVP for Strategy & Communications, ABIM and ABIM Foundation
• Susanne Stoiber, MS, MPH – Executive Officer, Institute of Medicine
• John Tooker, MD, MBA – EVP and CEO, American College of Physicians
• Reed V. Tuckson, MD – SVP, Consumer Health and Medical Care Advancement, UnitedHealth Group
• Thomas Voluck, MD, JD -- Medical Officer and Senior Adviser, Centers for Medicare & Medicaid Services
• Kevin Weiss, MD – Director, Northwestern University Feinberg School of Medicine
• Daniel B. Wolfson, MHSA – EVP and COO, ABIM Foundation

About ABIM Foundation

The ABIM Foundation is a not-for-profit organization dedicated to reflecting and supporting medical professionalism, physician leadership, science-based medicine, and health care of the highest quality. Its mission is to advance medical professionalism and physician leadership in quality assessment and improvement by: exploring what it means for physicians to be professionals; stimulating physicians to become involved in quality assessment and improvement; bringing diverse groups of leaders together to enable dialogue and consensus; and promoting research into the science of quality evaluation and improvement.

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