Sarah Kliff, who covers health care policy for the Washington Post, has published an insightful article on Oregon’s effort to make high quality care less expensive. The effort is based on the Pareto Principle, also known as the 80-20 rule.
The data from St. Charles Hospital in Bend showed that 144 patients tended to use the emergency room the most. Taken together, they averaged 14.25 trips each over 12 months. These patients drove much of the area’s Medicaid spending.
The team focused on the small number of patients that are responsible for most of the spending, consistent with the Pareto principle, with a goal to lower their cost of care with an integrated approach.
The stakes are high. A health care professional in rural eastern Oregon commented that now she can treat the root cause of problems such as tooth decay (yes, pun intended…) by making a referral to a dentist, which was not possible until the recent changes. She is “cautiously optimistic” that the changes will have a positive, lasting impact. As an engineer by training, I share her cautious optimism that a data-driven approach, focused on the right outcomes, will be successful.