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Friday, July 16, 2010

SNHMC picked for health care collaboration

CONCORD – Southern New Hampshire Medical Center in Nashua is one of five test sites to devise a new paradigm in health care where patient outcomes and lower costs are rewarded over more tests and more expensive treatment.

Gov. John Lynch announced the five accountable care organizations that will spend the next five years crafting a strategy on how best to lower the spike in health care spending that’s run eight times above the cost of living.

“Right now, we are not spending our health care dollars the right way, but that is about to change,” Lynch said at a news conference Thursday.

This Accountable Care Health Organization Pilot Project seeks to be competitive in getting a piece of incentive grants in the federal Obama health care reform law to reward providers that “bend the cost curve.”

SNHMC Vice President of Administration David Cawley said the aim is to change the mindset from numbers of patient visits and procedures to greater efficiency of care with better customer results.

“We keep score on how many widgets we make,” Cawley said during an interview. “We have to find a new way to measure our effectiveness.”

Dr. Emily Blatt directs the Advantage Network Physician Health Organization for the Nashua-based hospital system.

Local health leaders were already working on ways to cut re-admissions and reducing the use of the emergency room, she said.

“The timing we think is really good for us, and we have a lot to learn from the other participants in the pilot,” Blatt said.

Cawley said modest success in cutting costs would translate into tens of millions saved in spending statewide.

“We aren’t going to lower health care costs by 10 percent. But if we can start tracking at 4 percent (inflation), we will have made incredible progress,” Cawley said.

Lynch said two years ago, he charged his Citizens Health Initiative to come up with a new model, since consumers and government in New Hampshire spend much more on health care than the national average.

New Hampshire’s average family health insurance premium – at $12,686 in 2006, the most recent year for comparison – was one of the highest in the country.

Per capita spending in New Hampshire on health care of $6,456 in 2007 is forecast to soar 70 percent higher to $11,043 by 2017.

“The current financial rewards in our health care system are backward,” Lynch said. “Study after study shows higher costs do not translate into better care.”

Dr. Phil Boulter with the health initiative said the first year will be spent mapping out a strategy, three years of experience and the final year to evaluate performance of the pilot.

“Change is not easy,” he said. “Change in health care sometimes seems to be impossible.”

Art Nichols, chief administrative officer of the Cheshire Medical Center and Dartmouth Medical Clinic in Keene, said his group lost money when it lowered hospital admissions, cut the length of stay and cut spending on Medicare for seniors.

“You need to have a mechanism to share a portion of these savings,” Nichols said.

Scott Colby, executive vice president with the New Hampshire Medical Society, predicted the teams would love the freedom of breaking from the status quo and focusing on patient success and not numbers of procedures.

“This gets away from the constraints of fee for service,” Colby said.

The rival campaign of Republican candidate for governor John Stephen said Lynch exposed himself as a fraud on lowering costs in coming out for President Barack Obama’s universal health care law.

Stephen supports market-based reforms, his spokesman said.

“If Governor Lynch were serious about lowering the cost of health care, he would join John Stephen in working to allow New Hampshire residents to buy health insurance policies across state lines and reducing insurance mandates, so that we could bring real competition to the citizens and employers here,” said Communications Director Greg Moore. “That would result in more choices and less expensive health insurance for the public.”

The other three selected providers along with the Nashua and Keene hospital networks are a North Country initiative of hospitals and home health groups, the Central New Hampshire Health Partnership based in Plymouth and Bristol, and Exeter Health Resources.

Kevin Landrigan can be reached at 321-7040 or