Hospitals, employers each have crucial roles in making reform succeed
shift in the role of hospitals in American life.
First, the law contains provisions to keep people from needing hospitals, including myriad wellness and prevention incentives, expanded primary care and penalties for to achieve goals for reducing hospital acquired conditions and improving quality.
Many of these ideas came from purchasers. During the past few years, purchasers have launched innovative wellness programs, embraced the idea of patient-centered medical homes and implemented dozens of pay-forperformance programs to better tie their payment to the level of excellence they expect for their employees’ healthcare. Some purchasers have even partnered with hospitals to help them apply safety and quality strategies from other industries. Yet the pace of change is glacial or nonexistent. Studies do not suggest significant improvement in safety or quality of hospitals over the past decade, though costs have risen by more than 100%.
There are exceptions, and some of those exceptions are purchaser-driven. For instance, exactly 10 years ago, purchasers formed my organization, the Leapfrog Group, to measure hospital performance and use the information to drive purchasing strategies and consumer decisionmaking. Studies of data from Leapfrog’s annual hospital survey demonstrate that Leapfrog-reporting hospitals have