Comments on: How UCSF Is Solving the Quality, Cost and Value Equation

By: Smokey

Smokey — Sat, 13 Dec 2014 18:27:02 +0000

While UCSF may be trying to bring down costs, who benefits? Surely they do not pass on the cost savings to the patients. Under my insurance plan a simple two view X-ray at UCSF is $375, at a nearby radiology center it’s only $45. A lower spine MRI at UCSF is about $4,000, at the radiology center it’s about $475. I saw a student physical therapist and got charged $300. I saw a PA for three minutes in urgent care–$400.
Hospitals are big business, many have turned their emergency rooms and urgent care centers into big profit centers. Some have discontented most of their services and only offer the most profitable services.
One of the most irksome things as a consumer is the inability to get pricing from a hospital in advance. I’ve called and tried to get pricing from UCSF but I’ve been told they don’t know… that’s if they return my calls at all.
O.K. I’m done ranting.

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By: Shiva

Shiva — Sun, 02 Jun 2013 02:28:41 +0000

In reply to h2 advocate.

So funny… so true… actually happened @ UCSF too!

By: Mighty Casey

Mighty Casey — Fri, 31 May 2013 22:30:47 +0000

It’s a start. But as others have noted above, until the costs/pricing are (a) visible to all; (b) attached to shared decision making, root and branch; and (c) embraced from the C-suite to the admit desk … it ain’t soup yet.

I had the pleasure of talking to Chris Moriates and his UCSF colleagues at HM13 as part of my work for The Hospitalist. I hope that he, and other young guns inside the US hospital system, can drive some change in HIT vendor thinking (yes, Epic/Cerner/et al, I’m talking to you) and in the admin-brains running academic hospitals today.

It’s important to be able to manage revenue. However, as a patient, I think it’s even more important to help us help YOU figure out if you’re actually delivering value for that revenue …

By: h2 advocate

h2 advocate — Thu, 30 May 2013 20:24:06 +0000

Typical health-tech cost reduction idea conversation:

StartUp: “We have a great way to decrease costs significantly and increase patient satisfaction, it’s ____.”

Hospitalist: “Awesome idea. We just gave Epic $165 million dollars. Again. Does it integrate to that?”

Epic: “F*ck you. No one gets to enter our market. Integration questions closed. Now kindly piss off.”

Hospitalist: “So what did Epic say? Nice guys, right?”

By: Barry Carol

Barry Carol — Tue, 28 May 2013 21:45:13 +0000

In addition to the need for both internal and external price and quality transparency tools, we need doctors to view knowing and caring about the cost, quality and effectiveness of services, tests, procedures and drugs before they order or prescribe them as an important part of their job. Of course, to do that, we need to put all the appropriate information at their fingertips in a user friendly and easily accessible format.

It should be easier for salaried doctors to change their behavior in this manner, especially if they are hospital employees as opposed to private docs with hospital practice privileges. For fee for service doctors who might perceive a greater threat to their income, it will be more of a challenge.

By: southern doc

southern doc — Tue, 28 May 2013 19:03:43 +0000

When is UCSF going to stop charging facility fees for out-patient care?

By: rp

rp — Tue, 28 May 2013 16:13:42 +0000

This all sounds great in theory, but when will hospitals agree to share meaningful, standardized cost and quality metrics openly, on the Internet, with employer payers as well as individuals? Purchasers and patients desperately need this information to make informed choices about where to purchase and seek care. (And, by the way, it is entirely possible to control for the complexity of cases when calculating these metrics.) Also, why aren’t doctors above a certain age (65 or 70, say) tested for basic physical and cognitive competence, like airline pilots? Only this type of willingness to undergo scrutiny and provide transparency will truly revolutionize healthcare. As long as the healthcare industry is veiled in protectionism nothing will really change.

By: Dr P

Dr P — Tue, 28 May 2013 15:34:25 +0000

As a patient at UCSF and a Quality Program leader at a Health Plan, UCSF does some things right and some things wrong. The doctors outside of the hospital need to work on Customer Service…if they are not pleasant to people then patients, including myself, are reluctant to visit them. UCSF, just like many similar institutions (Stanford) do not understand how to optimizerevenue. It’s really quite simple but the size of the organization overstates the complexities of simple to implement stratagies. Contact me for further explanation.

By: Archelle Georgiou, MD

Archelle Georgiou, MD — Tue, 28 May 2013 12:35:42 +0000

Hospitals’ $84B of annual medical equipment expenditures are one area for cost reduction that Dr. Wachter didn’t highlight as an opportunity for hospital cost savings. Hospitals typically focus on the cost of new equipment but 75% of the $81 B is spent after the initial purchase–on service, maintenance, and disposition–frequently at the mercy of equipment manufacturers.

Hospital executives have little or no data transparency relative to the fair market prices for the equipment they buy every year, the fairness of the trade-in values they are offered from manufacturers, cost-efficient alternatives for service needs, and the true incremental clinical value of the “new new” equipment seductively laid out to them by equipment reps.

As a result, estimates are that $10 B of the $81 is wasted. What does it mean to hospitals? About $11 K per bed per year.

In our personal lives, none of us would buy a car or accept a trade-in offer without getting some comps from Edmunds or the Kelley Blue Book. Its time that hospital executives do the same when making medical equipment spending decisions.

http://www.startribune.com/business/208886711.html