By Brian E. Clark
For WisBusiness
Former state Insurance Commissioner Jo Musser is convinced that data from a new group called the Wisconsin Health Information Organization will improve medical care and save money.
How many dollars it might save is unknown, acknowledges Musser, who served from 1993 to 1999 under former Gov. Tommy Thompson.
“But we do know there is 30 to 60 percent waste in the health care delivery system at this time,” says Musser, who oversaw the Office of Health Care Information in the insurance commissioner’s office.
“Most providers would agree with that, as well as other stakeholders. So we are not just talking just about insurance administration, but delivery of care itself.”
With debate over federal reform efforts continuing, health care has been in the news for months now.
Musser says the WHIO’s work is significantly different from the federal health care reform effort, which she says is focused on insurance reform over controlling costs.
“Our efforts focus on trying to change the delivery system, improve quality and reduce the cost of delivery of care,” she says, adding “there is nothing in the federal debate that even comes close to addressing the underlying costs of care.”
“Focusing on insurance reform will help accessibility,” she says. “But it’s not going to reduce premiums or make things less costly. That’s just the financing mechanism.”
Musser became an executive with WPS Insurance after she left the insurance commissioner’s office. She is now vice president for business development at WHIO, which made its database available in September. She says the organization has been in the works for more than five years and consists of top insurers, hospitals, physicians, major employers, government agencies and health care quality organizations.
She calls WHIO one of the largest and most comprehensive sources of comparative health information in the United States. The goal of the group’s Health Analytics Exchange is to “deliver actionable information to those on the front lines of the health care system.”
She said providers wanted to participate in WHIO because they were concerned that insurers were measuring them with different yardsticks and wanted some input into the process as well as some standardization.
This information can help providers focus on what she calls “quality opportunities.”
“A diabetic, for example, really should have a retinal exam once a year and should have their LDL cholesterol measured annually,” she says. “So the analysis of the data checks to see if the docs are providing that or are missing it.
“So what we are talking about is improving the quality of care in the most efficient manner. We help doctors understand their resource utilization and patient care compares with their peer group. Ultimately, it should improve care and save money.”
She says the state’s Health and Employee Trust Funds departments are involved with the project and will be using the data to provide some type of public reporting in the future.
Musser acknowledges that there was more than a little resistance from doctors at the outset.
“There was a lot of trust building that had to be established early on,” she says. “That’s why it’s taken five years plus to get this going. … before we took it out for wide availability, we spent a lot of time internally selling it to the provider community. There was a fair amount of resistance and trust building that needed to happen.”
She says WHIO aims to get waste and inefficiency out of the health care delivery system by showing physicians how they perform compared to their peers and what kind of resources other doctors use to treat the same diseases.
“By providing them with that good data, we believe that physicians will respond by improving their performances and doing so in the most efficient manner,” she says.
Some physicians may drag their feet, but Musser says she is convinced most doctors will respond to WHIO’s information.
“I think physicians respond very well to good data. They are trained to do that. That is their aptitude. I think they genuinely want to do the right thing,” she says.
