As payers and patients seek higher quality and lower costs, they're asking providers whether some expensive healthcare services are absolutely necessary.
Last year, a guide called the Dartmouth Atlas of Health Care showed the healthcare world that providers vary widely in how they treat such conditions as pneumonia, breast cancer or enlarged prostate glands. The guide established a link between higher capacity and higher utilization rates.
Healthcare executives can learn how to use such information to manage resources and get an edge on their competitors at a seminar from 8: 30 a.m to noon Tuesday, March 4, titled "Understanding Variation: The Key to Managing Care and Managing Costs."
The session will be led by John Wennberg, M.D., the Dartmouth Atlas' lead author, and Jonathan Lord, M.D., the American Hospital Association's senior adviser for clinical affairs.
The atlas' authors contend that healthcare consumers will be reviewing data such as that included in the Dartmouth Atlas when considering which providers to include in their networks.
Providers who understand utilization patterns in their communities and try to outperform their competitors in reducing inappropriate services may have an edge in the future healthcare marketplace.
"Hospitals had better be prepared to deal with employers, insurers and patients that are better informed about what their options ought to be," says Megan Cooper, editor of the Dartmouth Atlas. "Anybody who's paying for this stuff is not going to want to be buying heart surgery in a place where the heart surgery rate is twice the national average."
Lord says the atlas indicates clinicians have a mental "rheostat" attuned to the availability of specific services in their communities. The more available the service, the more likely the clinician is to refer patients for it, even if the service doesn't improve a patient's life.
But Lord warns that providers must be cautious when using such tools as practice guidelines because they actually can work counter to the goals of reducing unnecessary services.
"Local clinical guidelines tend to reinforce local (practice) patterns," Lord says. "What they've done is memorialize their own practices."