Hospital Puts Docs On the Spot To Lower Costs

Summa Akron City Hospital in Ohio is doing something unusual: sharing data with doctors on how much their patients and procedures cost the hospital.

The hospital is participating in one of the many experiments that the Affordable Care Act set into motion to help figure out how to reduce the nation's skyrocketing healthcare costs.

The hospital has signed up two groups of doctors — cardiothoracic surgeons and cardiologists — to compare each doctor's costs per patient. The doctors are seeing all types of information, including how much they're spending on drugs, labs, and implants per patient; how much time they're in the operating room; and how often their procedures are starting late. Operating rooms are the most expensive rooms in a hospital, so when a surgery starts late, that means a very expensive room is sitting empty.

"I can tell you for the physicians in general, yes, it's uncomfortable," says Ken Berkovitz, chairman of the Department of Cardiology at the hospital. He says doctors know what it's like to be compared on quality — for example, they know how many of their patients have to be readmitted because of complications — but they have never been compared on costs.

For Berkovitz, the data revealed that he was prescribing his patients more expensive drugs and that other cardiologists who were prescribing equally effective, lower-cost drugs. "What's brought me to change is looking at the data," he says. "I probably would not have changed so quickly had I not had the data shared with me."

The doctors have been meeting with teams of nurses and administrators to discuss the data and figure out more efficient and cost-effective ways to care for patients. Deirdre Baggot, a healthcare consultant with the Camden Group leads these meetings. Baggot says that in the U.S., an estimated 25 to 35 percent of what hospitals do is wasteful and doesn't improve outcomes.

"Physicians are innately competitive," Baggot says. "So I know after session one that change will happen. It happens the minute they leave the room because they were always the top of the class, and they want to do that here."

But sometimes the story that the numbers tell isn't clear. For example, one of the cardiothoracic surgeons at the hospital was taking a lot longer in the operating room - and costing the hospital more than other surgeons - but his patients appeared to be doing better after surgery. Their readmission rates were much lower. Baggot says in a case like this, you might accept the longer operating time. But more often than not, she says, cutting costs and improving outcomes look exactly the same.

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