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Billings Clinic: High Quality Care at Lower Cost

Posted By Prucia Buscell, Thursday, August 13, 2009
Updated: Thursday, February 17, 2011
The PBS News Hour with Jim Lehrer has featured the Billings Clinic as an example of how high quality health care can be provided at relatively low cost.

In a special segment of the program, aired August 12, health correspondent Betty Ann Bowser visits the clinic, in Billings, Montana, and talks to doctors about the clinic's model of integrated patient care and clinic's participation in a Medicare project designed to reduce costs and improve patient outcomes. The segment opens with President Obama citing the Mayo Clinic and the Cleveland Clinic as examples of providers of high quality and lower cost care, and asks the question: what are they doing that's different?

Billings, which is modeled after the Mayo Clinic, is introduced as another facility that is doing differently, and better. With 3,500 employees, it is the largest multi-specialty medical group practice in the state, and treats 148,000 patients annually at a dozen locations. Physicians at Billings, even the high end specialists, are employees who are paid a salary, rather than working as independent contractors. Dr. Doug Carr, medical director, says that means doctors are paid for what they do forpatients, without regard to the type of insurance reimbursement the patient has or the number of tests ordered.

Two years into the Medicare project, the average annual expenditure per Medicare patient at Billings is $6,332, well below the national average of $8,304. Dr. Carr says coordinated care, including the benefits of a telemedicine program for patients at a distance, saved $1.5million in avoided hospitalizations.

The Billings Clinic was a beta site hospital in the Positive Deviance (PD) Methicillin resistant Staphylococcus aureus (MRSA) Prevention Partnership, spearheaded by Plexus Institute and funded by The Robert Wood Johnson Foundation. Nicholas Wolter, MD, the CEO of Billings Clinic, was one of the founders of Plexus Institute. From Invisible to Visible: Learning to See and Stop MRSA at Billings Clinic, the story of how the Billings Clinic used PD to reduce MRSA infections by 84 percent, is available at the Plexus Institute website in the e-library.

Tags:  buscell  complexity matters  healthcare  MRSA  positive deviance 

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