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SALT LAKE CITY (AP) -- When it comes to improving medical care and holding down skyrocketing costs, Intermountain Health Care is doing better than many other health-care networks.
IHC is No. 1 for a second year in a ranking of the nation's top 100 health networks by Chicago-based research firm Verispan, which grades the providers according to their financial and clinical performance.
Verispan released the 2003 ranking in March, and IHC executives sat down with The Associated Press last week to discuss their nonprofit business. IHC was created when The Church of Jesus Christ of Latter-day Saints relinquished ownership of its hospitals in 1975. It set up a board of trustees for IHC that now consists of 22 Utah business leaders, doctors and professors.
The Utah provider is showing how a few simple concepts, though difficult to adopt in the larger and highly fragmented health care industry, can make all the difference, IHC chief executive and president Bill Nelson said.
Huge variations among doctors in medical procedures often lead to shoddy care and spiraling costs, according to studies by the National Academy of Science's Institute of Medicine since 1999, when it came out with a highly publicized report on medical mistakes.
If the industry could just standardize the best, proven practices of medicine, "we would significantly improve the health care of our people" and save money, Nelson said.
"This stuff sounds so simple," he said.
Take elective birth induction. In 2000, IHC discovered that 27 percent of all births at its hospitals were being induced a week or more before full term simply for the convenience of the mothers or doctors and in violation of guidelines adopted by the American College of Obstetricians and Gynecologists.
IHC's latest figures show that less than 9 percent of induced births in 2002 varied from criteria set by the college. That has halved the number of birth complications to 2.6 percent of all deliveries, saving expensive trips to the intensive care ward.
IHC's advantage comes from its unified network of 1,900 staff and affiliated physicians, clinics, health-maintenance organization and 20 hospitals in Utah and another in Burley, Idaho.
Annual evaluations by the Utah Department of Health put IHC in the lead in the state where it controls half of the health-care market. The reports show IHC's hospital charges are 17 percent lower than rates of non-IHC hospitals in Utah, such as St. Mark's Hospital or University of Utah Hospital. And IHC leads in most medical categories and satisfaction among HMO members.
Take heart-attack patients.
IHC discovered that by simply handling all heart patients their medication when they leave the hospital, it can save 450 lives a year and lower health costs.
A national study found that only 45 percent of heart patients get their medicine at discharge. Many of the rest forget or aren't reminded, or their specialist and regular doctor assume the other is writing the prescription and it doesn't get done.
Dr. Greg Schwitzer, IHC's vice president of clinical programs, blames this on an "information morass" and says doctors often are so busy they overlook the basic stuff.
Many doctors also ignore medical guidelines from their own national associations, dismissing the rules as inapplicable to their patients or way of doing medicine, he said.
"There's no bad guys here," said Daron Cowley, IHC's public-relations director. "It's just the complexity of health care and lack of systems."
Traditionally, doctors worked on their own, and hospitals operated on their own, leading to gaping disparities in medical care.
A study published last month by New England Journal of Medicine found that U.S. doctors fail to take nearly half the recommended steps for treating common illnesses such as high blood pressure and diabetes.
Nelson said it's taken IHC 10 years to build a unified medical, accounting and billing system. The network's 400 staff physicians and 1,500 affiliated doctors work from the same page, applying the latest and best methods of medicine. IHC pays its own doctors based on performance.
"It's accountability," said Nelson, emphasizing the bottom line.
(Copyright 2003 by The Associated Press. All Rights Reserved.)
