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Executive Sims' charge to the
Health Advisory Task Force
Dec. 16, 2003
"The challenge before us is to find a 21st Century model to
provide quality health care while managing
the spiraling costs of health care. The things we have all been doing in the past are no
longer enough to insure quality and contain costs.
I refuse to accept that the only strategy left to employers is to either shift significant costs to
employees or make substantial reductions in health care benefits. It is time for bold, innovative
strategies that address the parts of health care delivery that are clearly not working.
We will follow the lead of the medical community in looking at a quality, cost effective health care
system that is patient centered.
Everything I have read and heard about the American health care system focuses around three main issues:
- The normal market forces do not operate in health care. For example, King County
employees, are essentially using the county’s “credit card”. Employees choose whatever care they need
or want, providers deliver whatever care they deem most appropriate, and the bill gets paid by the county.
- The employee is not well informed of costs, quality or options;
- The provider is rewarded for providing more treatment and is not rewarded at all for disease
prevention or disease management; and
- The employer has no control over the quality, appropriateness or efficiency of the services for which it pays.
- This situation is not unique to King County.
- It is not the routine health care services that are the big drivers of the cost trend; the
big drivers are chronic conditions (which can be managed) and catastrophic events
(which cannot.)
- Several major studies including those done by the Dartmouth Center for Evaluative Clinical Science and the Institute of Medicine indicate
that 20% to 30% of health care spending goes for procedures, visits, drugs, hospitalizations and treatments
that do not improve quality or extend life.
- I believe that the best way to reduce the cost burdens on everyone and raise the quality of health care
for all is through a 3-part strategy:
- Engage and enable employees to become informed health care consumers –
provide employees with information and tools they need to invest their health care dollars wisely based on quality,
cost, proven effectiveness and value.
- Reinforce and reward provider and patient focus on wellness, disease management
and active participation in health care decisions.
- Establish consensus-based standards of health care cost and quality measurements
designed to provide meaningful information about whether care is safe, timely, beneficial, patient-centered,
equitable and efficient.
My charge to this task force is provide guidance in two areas:
- Conduct a reality check for King County: Has King County accurately
defined the problem and identified the most realistic, most actionable elements to achieve quality of care
and cost containment in its own employee health plans?
- Make recommendations on partnerships and processes that are needed to establish a system of quality and cost performance measurements
for the Puget Sound regional health care market. These measurements should be publicly available and
provide meaningful information for all levels of care: health plans, hospitals, medical groups,
individual physicians, and employees seeking health care services."
Ron Sims
King County Executive
Health Care Advisory Task Force home
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