CT Center for Patient Safety
CT Center for Patient Safety Newsletter
April, 2013
In This Issue
Improving Cancer Care
New isn't necessarily better
Health insurers spent less
Connecticut gets an F!

Improving Cancer Care


Some of the statistics are alarming. This coming year 1.6 million Americans will be diagnosed with cancer. Their treatment will consume 5% of our healthcare dollar and is the fastest growing segment of the healthcare industry. Ezekiel Emanuel wrote a thoughtful op-ed piece for the New York Times. As patients we need to be fully informed about treatment options, costs and expectations.


It is recommended that five major changes occur: 1. do away with the current fee for service payment model: 2. insurers and medicare need to tell doctors and patients how much their care will cost. Docs often have no idea of the real cost of various treatments and tests. 3. Measure quality outcomes to ensure that there is neither under- nor over-utilization of care. 4. bring nurses into the picture earlier in treatment, improving the quality of care, 5. research what treatments are working and what are offering no benefit.


These are of course common sense solutions and are often resisted.

New isn't necessarily better

Each Tuesday, the health and science section of the New York Times provides thoughtful articles that address many of the issues that concern us. On March 26, Salesmen in the Surgical Suite, Roni Caryn Rabin wrote about Intuitive, a California enterprise that manufactures robotic equipment and markets that equipment to hospitals across the country.  The equipment is called the daVinci Surgical system and the journalist found company emails that showed aggressive marketing tactics. The article raises important questions that you should raise if this type of surgery is recommended.  The most important question is regarding the training of the surgeon in using this equipment and how many surgeries he or she has done.   You should also be sure to ask what were their results?

Quick Links
have you visited our website recently? It is a rich source of news and resources for patients and families.
Like us on Facebook
Visit our blog
Dear Members, 
I need your help. In the next few weeks I will be a panelist at two very different events. Let's discuss the easy one first.

The Citizen Advocacy Center in DC wants to know what patients want from Department of Public Health websites. I am curious to know about your experiences.
  • When have you visited the website?
  • Did you find what you were looking for?
  • How could the site be more user friendly?

The second area is a little more complex. The buzz words right now are "patient engagement". Yet, it is becoming clear that what that means to the patient and the provider are quite different.

  • Can you give me examples of when you felt the provider "engaged" you?
  • Can you give me some techniques on how you "engaged" the provider?
  • Have you ever been surveyed about preferences in receiving care?

My favorite example of the latter is a primary care practice that asked patients what they liked or didn't like. Everyone hated being weighed when they first got there - the worry over their weight, they felt, also increased blood pressure readings. The practice changed their procedures and now the patient is asked how they have been since their last visit.


Small acknowledgements of who we are as humans can improve every day experiences.


I look forward to hearing from you. Share your thoughts by following this link: CTCPS Contact Form


Jean Rexford
CT Center for Patient Safety
Health insurers spent less than 1% of their premium dollars on care improvement.
Mark Hall and Michael McCue, the principal researchers, concluded that on average, insurers spent $29 per subscriber on quality improvements.
Connecticut gets an F!


By Russ Mitchell


Wonder why you can't get a straight answer on how much a health care procedure will cost you? One big reason: State laws which allow hospitals and other providers to keep costs hidden until they send you the bill.

A report card on price transparency released today gives 29 states an "F" and seven states a "D" for policies that keep patients and their families in the dark on prices. The failing grade went to those with practically no transparency requirements.

Only two states, Massachusetts and New Hampshire, rate an "A," and even they could improve their laws, according to the report by the Catalyst for Payment Reform, a consortium of health care purchasers such as GE, Wal-Mart and The Boeing Company, and the Health Care Incentives Improvement Institute, a nonprofit group seeking to improve health care with evidence-based incentive programs.


The high prices that American health care providers charge, often with little connection to actual costs, have been in the national spotlight since Time magazine devoted its entire March 4 issue to an investigation by Steven Brill.

Most consumers are unaware of the tremendous variation in price. For instance, prices for knee replacement surgery in the same California market can range from $15,000 to more than $100,000, depending on the hospital, with no discernible difference in quality.


High deductible insurance plans are becoming more common, with employers hoping consumers with "skin in the game" will shop around to help keep prices down. But, the authors note, consumers cannot make informed decisions without being able to comparison shop on the basis of either price or quality.

"Consumers deserve to have as much information about the price of their health care as they do about restaurants, cars, and household appliances," the report says.


The grades reflect the quality and scope of the pricing data that states require and how well they disseminate it - public websites gain high points, for example. The grades also discriminate between 'charges,' the prices that hospitals say they charge for services, and what a consumer and her insurance company actually pay for them. There is often little connection between the two. States that require disclosure of actual prices earned higher grades.