Smart savings in health care : 1800 ideas from practice
How to save in health care without touching upon quality of care? Itinera presents 1800 ideas from the sector. Physicians, directors of hospitals, elderly care,… support progressive steps forwards to implement structural reforms. This is a reflection of the vision, courage en a sense of responsibility of the sector. 283 million euro are within arm’s reach in a relative short term if such initiatives would be launched. The resulting savings will be needed to cover the cost of aging and the necessary growth of care. Policy plans of government also testify of an increasing positive vision on themes of ‘smart care’ such as human resource management and IT. Other domains such as financing of care should be added. Most of all, it is time to abandon the divide between vision and budgetary rounds.
Government has to find 2.5 billion euro during the current budgetary round. The health care sector can contribute up to 300 million euro if structural reforms are initiated. Freezing of tens of millions of planned investments is not a good idea. The same is true for hollowing out the growth rate of 2%. Indeed, hundreds of millions need to be invested to cover the cost of aging and related care needs. However, the sector has proposed a rich set of ideas: 93,5 million by reducing nosocomial infections and readmissions, 36 million euro in dialysis, 90 million euro through administrative simplification, 50 million by reforming patient fees, saving 300 euro by investing 30 euro in smart prevention, saving 8 euro by investing 1 euro in the reduction of fraud. Up to 25% of all care expenses can be reduced by smart IT.
Some of the interesting ideas of the sector include: (1) Recalibrate physician fees in a systematic way, in line with the up to date evidence and costs; (2) Implement a larger portion of fixed payment and introduce quality incentives; (3) Shift HRM from a rigid policy driven by rules and degrees towards a flexible policy driven by task shifting, competences and job enrichment; (4) Implement an online patient managed integrated and uniform healthcare record shared by all care providers; (5) Reduce the administrative burden; (6) Demand the use of decision support tools by providers to support appropriate clinical decision making; (7) Make room for new technology by cutting outdated or ineffective technology; (8) Reform patient fees in line with the appropriateness of care; (9) Save in expenses by increasing preventive measures which have proven to work; (10) Monitor and sanction the occurrence of fraud in health care.
