Last week a study from Wennberg's Dartmouth group found that there were vast variations in the amount of "physician resources" used to produce similar care outcomes in intensive care settings. This week a RAND study followed up on data released in their much-quoted 2003 study which showed that patients receive the correct care from their providers only a little over 50 percent of the time. This new study showed that there was little difference between the care meted out to richer, better-insured people and that given to poorer, less well-insured minorities. So it appears that unlike in the rest of American life, money can't buy you better quality. Given the amount of money being spent on healthcare in America, that's not a satisfactory outcome.
Putting these two studies together shows that there will be much more concentration in the resources being used and the process and outcomes of care. Most importantly, it shows that the intellectual argument has been created for providers to be paid for quality, performance and by extension cost-efficiency. This will not be an easy change for the system to adopt, and it looks as if it may be the major story of the next decade. - Matthew