You get what you pay for, the adage goes. But when it comes to healthcare quality, you don't get what you don't pay for.
"So many healthcare organizations are concerned about cost-reduction efforts-downsizing and restructuring," says Bernard Horak, an associate professor of health services management and policy at George Washington University in Washington. "There's been an overemphasis on cost reductions to the detriment of quality and customer satisfaction."
Horak will describe how to avoid cutting quality while cutting costs at the seminar "Balancing Quality and Cost in Healthcare: 10 Current Approaches" at 10: 30 a.m. and 2: 15 p.m. Tuesday, March 28.
Doris Reinhart, a consultant with Kessler Rehabilitation Corp. in West Orange, N.J., will share the podium with Horak. They have done consulting work together, and Reinhart also teaches some classes with Horak at GWU.
"In defense of hospital administrators, I happen to believe that most administrators assume quality," Reinhart says. "They assume it's there. Therefore, they don't think about bringing it forward."
However, payer demands have forced healthcare providers to trim out the fat and operate more efficiently, pushing the price of care to the front burner.
"A lot of facilities began to downsize very quickly and reduce labor and supply costs very quickly," Horak says. "They didn't pay enough attention to the quality side. We may see more medical errors and medication errors. That's starting to show up."
Horak and Reinhart say they have been interested in quality for years, long before the watershed Institute of Medicine report on medical errors came out late last year.
"Our presentation was developed way ahead of that," Horak says. "But we could almost anticipate that report coming out."
Reinhart also says she was not surprised at the IOM's findings, which estimated that medical errors cause 44,000 to 98,000 deaths annually in the U.S.
"We've seen a few studies out there saying, `This is what's happening,' " Reinhart says. "Don't we need to step back and look at what we're doing?"
With that in mind, Horak and Reinhart have developed 10 approaches
to balancing cost and quality.
In order to not compromise quality by change-indeed, to enhance it in the long run-quality must be the top priority in the chief executive officer's mind.
"It can be unintentional, but there can be an erosion of quality if it's not central to every decision," Reinhart says. "Quality has to be No. 1, and that has to come from the top."
Reinhart tells her CEO clients to ask themselves two questions whenever they make a decision: Will this enhance quality of care, and how?
"People love to say, `Of course this will enhance quality,' but I say, `Prove it,' " Reinhart says.