Accountability is a many splendored thing.
As healthcare organizations become bigger and more complex, it's darn near impossible to link individuals with specific decisions and outcomes. In too many cases, costly mistakes are covered up or twisted into oblivion in classic blame-game style.
But Richard Myers did the honorable thing by taking the fall for some messy financial discrepancies that occurred during his watch as chief executive officer of Durham (N.C.) Regional Hospital.
The county-owned hospital, which in 1998 signed a 20-year lease to become part of the Duke University Health System, was forced to make an unfavorable accounting adjustment of $8.8 million last year. The shortfall, which involved contractual reserves for managed-care revenue, was a major factor in the hospital's fiscal 1999 operating deficit of $12.7 million.
In attempting to reach an accountability equilibrium, Myers, 57, will end his stint as CEO by the end of the month as Duke seeks financial relief from Durham County. It's refreshing to see someone owning up to a mistake before the legal system gets involved.
Also in need. PPOs, healthcare's most important and fastest-growing component, also are in need of greater accountability.
Although PPOs are wildly popular with patients and payers, critics contend that they are little more than discounting networks that squeeze providers for lower fees. Most consumers have difficulty comparing PPOs.
With nearly 100 million Americans enrolled in PPOs, the entire healthcare industry should encourage efforts by the National Committee for Quality Assurance to develop standards for rating PPOs.
If the NCQA benchmarks are accepted, patients could see how PPOs stack up on appeals processes, provider credentialing, member satisfaction and other factors already used to measure HMOs and hospitals.
About 30 of the leading PPOs have agreed to participate in the new Consumer Assessment of Health Plans Study.
From there, we fully expect PPO accreditation to become usual and customary within a few years.