Quality and cost (SIDEBAR to Executive Profile, Dec. 2007)

An important component of the legislation that has not received a lot of press to date has been the Health Care and Quality Cost Council (HCQCC) which was established by the same health reform law that created the Connector.

"Consumers need new information on what quality means," says Kingsdale, who cites a 2003 study from the Massachusetts HCFP that found no significant outcome differences between non-high-risk deliveries at community hospitals and those at teaching hospitals.

"So people drive in from the suburbs, right past their community hospitals-where there are doctors who have been doing this for 20 years-to deliver babies at an academic center, where the quality of care is perceived to be higher," he says.

"This information is particularly important to consumers with high-deductible plans who pay out-of-pocket for many services," says HCQCC Executive Director Katharine London. "Making quality and cost information publicly available also will provide an incentive for healthcare providers to improve quality of care and to provide that care more efficiently."

HCQCC's mandate is to:

"The Massachusetts health reform law focused primarily on improving access to care, but the legislature recognized that containing healthcare costs is key to making health insurance affordable," London says.

The HCQCC is in the process of developing collaborative partnerships with health plans and work with plans and all sectors of the healthcare system to reduce healthcare spending by preventing the need for avoidable hospital stays.

"We know that a portion of our healthcare spending goes to pay for the results of poor quality. For example, additional spending is needed to treat patients who acquire an infection while in the hospital, patients who are readmitted for the same diagnosis within 30 days, and patients who ended up in the hospital because they did not receive the care they needed on an ambulatory basis," London says.