« Continue Browsing

e-mail article Print     e-mail article E-mail

Published January 28 2011

Forum editorial: North Dakota Blues prepare for future

The new health care law’s biggest flaw (among many) is that it does little to address the heart of the looming health care crisis: rising costs. Enter North Dakota Blue Cross Blue Shield and several leading health providers. Despite (or maybe because of) health care reform, the Blues and the providers have developed an “outcome based” initiative that aims to reduce the annual rate of medical inflation. Medical inflation is the primary driver of rising costs for health insurance and health care.

At first, the goal seems modest: Cut medical inflation from its current average of 8 percent to 6.5 percent in three years. But when viewed in the context of the escalating costs in the health care sector, the Blues and providers are talking about real savings from even a slight reduction. Some $30 million could be saved in the first three years and about $15 million annually thereafter.

Moreover, Blues’ chief executive officer Paul von Ebers said the initial goal is step one. If modest success is achieved, it’s possible more ambitious savings can be realized in the future.

Joining the Blues in the efforts are Sanford Health, Essentia Health (Innovis), both of Fargo; Altru Health of Grand Forks; and Trinity Health of Minot. Other providers have been approached and might sign on at a later time. They realize that the current rate of medical inflation is unsustainable. New methods and better outcomes have to be part of a smarter, leaner health care system if the insurance and care delivery systems are to remain viable for as many Americans as possible.

“The old model,” said Sanford chief medical officer Dr. Rhonda Ketterling, “just doesn’t work as well as we’d like.” The new way, as envisioned by the Blues and partners, will be grounded in incentives for positive outcomes, increasing quality of care and efficiencies, and preserving/enhancing the doctor-patient relationship.

The North Dakota Blues and partner health care providers already attain efficiencies and quality-of-care outcomes that are the envy of the nation. The new initiative is a logical enhancement of a system that is basically sound and responsive to patient needs. Such good planning will keep the regional health care sector ahead of the changes that are on the horizon. The collaboration will better help the Blues, Sanford Health and the others adjust to evolving requirements of the new federal health care law.

Given the size and ambition of the initiative, there will be bumps in the road. But it’s a smart way to go – for providers and patients – as the nation’s health care system confronts unprecedented challenges.

Forum editorials represent the opinion of Forum management and the newspaper’s Editorial Board.