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Children's Health Current Topics in Children's Health

Improving the Quality and Value of Health Care


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Summary & Participants

Improvements are necessary to make sure Americans get the best quality health care and that money for this care is being spent as effectively as possible. Listen as experts -- both in government and in the private sector -- describe some of the steps taken to improve the health care system.

Medically Reviewed On: July 21, 2008

Webcast Transcript


ANNOUNCER: Many Americans might be surprised to learn that there’s a 50/50 chance they do not always receive quality health care.

CAROLYN CLANCY, MD: We know from a number of studies that Americans, on average, receive just over half of recommended care when they see clinicians. And we know that it actually doesn't matter where you live. Care doesn't vary all that much across the country in terms of a gap between best possible care and the care that people routinely receive.

ANNOUNCER: One problem is that how doctors get paid is out of sync with practices that might reward better care.

CAROLYN CLANCY, MD: One of the big, big issues in quality of care has to do with how we pay for care. In general in this country, we pay more if doctors do more. And not surprisingly, that means they do a lot.

ANNOUNCER: The problem is very evident in treating diseases like diabetes or heart disease.

REED TUCKSON, MD: People with chronic diseases require a variety of services, not the least of which is the opportunity to spend time with a physician who is listening and thinking about how to prevent disease, how to prevent complications from disease, how to be able to help better manage it in a more holistic and comprehensive way. Unfortunately, the delivery system is much more favorably inclined to reward interventions that are procedural, doing things, applying technology, putting wires into hearts, doing surgeries, those sorts of things.

ANNOUNCER: Employers and insurance companies are beginning to make changes, to reward better care.

CAROLYN CLANCY, MD: A number of private sector employers have actually stepped up to say, "There is something wrong with this picture. We think that we could actually come up with a different program that says, 'We'll pay you more if you achieve certain quality goals.'"

ANNOUNCER: Experts say improving the quality of health care often saves money.

CAROLYN CLANCY, MD: There are many examples where improving quality of care actually leads to savings. For example, better care for diabetes can often prevent unnecessary hospitalizations down the road. The same for asthma and other kinds of conditions. There are other times when it's going to cost more to do it right, but doing it right the first time -- that is every time -- means that fewer resources will be wasted in the long run.

ANNOUNCER: To benefit from quality care and to reward its delivery requires information about how doctors and hospitals perform. This information can drive changes in how insurance companies pay for care; choices patients make about where they go for treatment; and it can encourage doctors, hospitals and nursing homes to do a better job. Making this information available is often called health care “transparency.”

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