, Salem, MA

April 28, 2011

My View: Best care is Partners' goal

My View
Robert G. Norton and Gary L. Gottlieb, M.D.

Our country's economy has undergone a major transition in recent years.

A substantial portion of the wealth we thought we had was an illusion. The federal government's debt is growing, and Massachusetts has a massive structural deficit.

Our country can't go on indefinitely with health care costs consuming an ever-larger portion of everyone's budget.

These factors have created a challenging new economic reality in health care: Federal and state governments are constantly reducing what they pay hospitals through Medicare and Medicaid. In fact, recent figures suggest that Medicaid only pays hospitals about 70 cents for every dollar of care provided to Medicaid patients.

This new reality has led North Shore Medical Center and the other hospitals of Partners HealthCare to rethink how we deliver care to make sure that we are doing so in the safest, most affordable manner possible. The more we can streamline and standardize how we deliver care to patients throughout our organization, the more we will enhance quality and reduce costs.

One significant way we can do this is by providing better care coordination for our most medically complex Medicare patients.

We know that about 10 percent of patients account for 70 percent of all health care costs. If we can coordinate the clinical care and other services like home care and transportation in order to help patients manage their disease, we can better maintain their health, allow them to stay in their homes and reduce costly readmissions to the hospital.

Right now, Partners' primary care physicians are pioneering this approach with an extraordinary Medicare demonstration project, which began at Massachusetts General Hospital. Locally, physicians in several of our North Shore Physicians Group practices work with care managers in their offices to provide individualized support for medically complex Medicare patients. We are making a difference in their health.

This demonstration project is a preview of what is to come. In the future, hospitals and physicians will be compensated for how well we keep patients healthy — not just by how many times the patient receives care. Our network of caregivers will be fully "accountable" for the overall health of the patient with a fixed amount of money — a "global" payment — from the insurance company, Medicare or Medicaid.

Caregivers from NSMC and other Partners hospitals are also applying science to standardize the best clinical practices for patients with common high-risk illnesses like colon cancer, heart disease, stroke and diabetes. By bringing together the best minds from NSMC, Brigham and Women's, Massachusetts General, McLean, Newton-Wellesley, and Spaulding hospitals, we are pooling our expertise to deliver consistently high-quality care across our system.

Wise use of technology can contribute to health care affordability, too. By implementing an advanced voice-recognition system, NSMC's Department of Radiology has dramatically reduced the turnaround time for dictated diagnostic reports. That means specialists can diagnose and treat patients sooner. That's better care. And, with that one change, NSMC is saving hundreds of thousands of dollars in medical transcription costs that are being reinvested in health care right here on the North Shore. That's more efficient care.

NSMC and Partners share an important mission to provide the highest-quality care to our community that is also affordable to society. Our mission won't change, but our internal culture is changing so we can continue to improve the care we deliver. We are confident that this kind of investment has the best return imaginable.

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Robert G. Norton is president and CEO of the North Shore Medical Center in Salem. Gary L. Gottlieb, M.D., MBA, is president and CEO of Partners HealthCare. To learn more, visit