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Web Preview: Health Care Award Winners Talk About Controlling Costs

By WBUR’s Martha Bebinger
(scheduled to air today on All Things Considered)

The child of Chinese immigrants who is transforming care for the elderly, a man inspired by the death of his brother and a woman whose leadership is described as a mix of acid and whipped cream are among those honored this year by the New England Healthcare Institute.

The awards showcase the work of these five men and women on improved patient care. We asked these health care innovators how what they’ve learned about improving care might translate to controlling health care costs.

Patricia Gabow

Let’s begin with the petite hospital executive who blends acid and whipped cream in running Denver Health, a national model in health care for the uninsured. CEO Patricia Gabow looks to other industry leaders: Fed Ex, the Ritz Carlton and Toyota and adapts their approach to her goal, improving patient care. Using Toyota’s LEAN model to analyze more than 300 procedures at Denver Health, Dr. Gabow says she found that about 60% of what has happening was waste.

“By taking out waste you improve quality and lower costs and make it (health care) more patient friendly,” says Gabow. “Who wants to sit in a waiting room or get a test you didn’t need? But unfortunately, in health care, a lot of what we think is waste is someone else’s income and that’s why it’s very difficult to change this system.”

Gabow says Denver Health is $66 million better off in savings and efficiencies since adopting the Toyota model. Now Gabow says she, like some hospitals in Massachusetts, is ready to test new ways of getting paid for health care. She expects to try global payments, where doctors and hospitals work under a budget for patients instead of getting paid for each office visit, test and procedure — what’s known as fee for service.

“You have to get rid of fee for service if you want to improve value and lower cost” says Gabow. “It doesn’t take a rocket scientist to say, if you pay people for doing more that they’re going to do more, this is human behavior.”
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