Pennsylvania Gov. Ed Rendell said this week that he will roll out a plan to lower health care costs by forcing hospitals and other care providers to be more efficient and make fewer mistakes.
The plan, to be unveiled fully in January, will probably spark broad complaints from the health care industry, Rendell predicted. For instance, he said, he wants to rewrite rules to allow nurse practitioners to play a greater role in patient care and create new regulations designed to guard against hospital-acquired infections.
“The test for us is, are we going to have the intestinal fortitude to look down the barrel of the special interests and say, ‘Uh-uh guys, not this time, health care is too important of an issue for the people of Pennsylvania,”‘ Rendell said during a traditional end-of-year interview with reporters.
Rendell said parts of the package would involve winning regulatory and legislative approval, and would also include an expansion of the state’s low-cost health insurance program for adults that he previously discussed.
A clamor against the rising cost of health care, he said, has created a mandate for the state to take action. Forcing down the cost of health care will be important to businesses that compete internationally with businesses that do not have to help pay for employee insurance, he said.
The state has a wider set of tools it can use to keep down costs in government health care programs, and Rendell said his administration will talk to business groups about what should be done in the private sector to cut health care costs. One idea, he said, is offering cash bonuses to employees who stay healthy, which the state already does for its employees.
“We save from our providers far more money than it costs us to give the incentive,” Rendell said. “Every employer in the state should be doing the same thing.”
In Medicaid, the health insurance program for the poor and disabled, the state will start paying health care providers for keeping patients healthy, instead of for simply treating a patient, Rendell said.
The state also has developed a preferred drug list that forces pharmaceutical companies to provide the drugs at lower prices if they want to be included in the health care program for 55,000 state workers. The program saved $60 million in a year, Rendell said.
In the private sector, he said, loosening rules surrounding nurse practitioners could mean providing care to a patient in a doctor’s office or emergency room at half the cost of a doctor’s care. Nurse practitioners are qualified to perform most of the duties that doctors do, Rendell said, and cited an example of a state regulation that restricts nurse practitioners to giving stitches in the presence of a doctor.
“Care won’t suffer at all, and by the way, we are one of the most backward states in the restrictions imposed on nurse practitioners,” Rendell said.
Chuck Moran, a spokesman for the Pennsylvania Medical Society, which lobbies on behalf of 19,000 active and retired physicians and medical residents and students, agreed that nurse practitioners could bring down costs.
But the society, he said, will want to take part in discussions to help decide what is best for patients.
“We want to be a part of the plan,” Moran said. “You’re really talking about redefining the health care team because costs are getting high and patient safety is a concern.”
He also said the state would write regulations to force hospitals to take basic steps toward cutting down on the number of infections that patients contract while in a hospitals’ care. The average private insurer’s payment for a patient who contracted a hospital-borne infection in Pennsylvania last year was almost $54,000. That total is more than six times the amount for a patient who did not contract one, the Pennsylvania Health Care Cost Containment Council said in a report released last month.
A spokesman for the Hospital and Healthsystem Association of Pennsylvania noted that there are already several sets of infection-prevention regulations — both government- and industry-written — to which hospitals adhere.
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