The Dartmouth Atlas, relatively unknown to the general public, has been whispered about for decades in health care circles. It sees the light of day now:
A provision in the House health care bill, included over the objections of hospitals from New York and other cities, would order a neutral group, the Institute of Medicine, to conduct a two-year study of regional variations in Medicare spending. The bill requires the institute to recommend changes that would reward “quality and value,” and those changes would take effect automatically unless Congress objected by May 31, 2012.
This is certainly controversial and attacks have begun on the validity of the data showing major differences in costs across all regions of the U.S. for similar procedures. This is an effort to reign in those costs in high-spending hospitals.
The CEO of Beth Israel rationally thinks through the issues, especially that of patient noncompliance, which everyone health care facility suffers regardless of region.
“I don’t dismiss the Dartmouth study out of hand,” said Stanley Brezenoff, chief executive of Continuum Health Partners, parent company for major New York hospitals like Beth Israel Medical Center and St. Luke’s-Roosevelt Hospitals. “What I’m saying is there may be explanations that go beyond the simple explanation of overutilization.”
“I now have my people poring over readmissions,” he said. “What we’re discovering are things like individuals don’t take their medications, and you ask yourself what it is that we as a hospital could do to deal with that.”