A group of 45 doctors, insurers and policy makers frustrated by the current state of health care are set to graduate tomorrow from a first-of-a-kind program at Dartmouth College designed to help them improve patient care.
The students are largely executive-level employees of the Mayo Clinic, UnitedHealth Group Inc. (UNH) and top U.S. hospitals. The Master of Health Care Delivery Science, with most classes taught online, was born of concern for shortcomings in how health care is delivered, said Robert Hansen, senior associate dean at Dartmouth’s Tuck School of Business in Hanover, New Hampshire.
Former Dartmouth President Jim Kim, who left the 244-year- old Ivy League school in July to run the World Bank, started the course to solve the “unsustainable burden of health costs,” said Katherine Milligan, director of the program. A government- sponsored study last week found that Americans are sicker and more likely to die earlier than peers in high-income countries, despite the U.S. spending more per capita on health care.
“We’re spending so much money and yet we know the outcomes in terms of quality are not as good as we’d like them to be,” Hansen said in a telephone interview. “It cannot be the same old way. It is not going to work. They’re looking for tools to find solutions that are scalable.”
If anyone knows about the frustrations associated with the wildly varying outcomes in the health-care system, it’s Dartmouth. The college produces the Dartmouth Atlas of Health Care that has for more than 20 years “documented glaring variations in how medical resources are distributed and used” in the U.S., according to the project’s website.
Most recently, the Atlas found treatment decisions for Medicare patients who could either take medication or have surgery depended largely on where they live and the clinicians they see.
Since July 2011, the students have gathered online once a week for video tutorials and attended classes at the Dartmouth campus every six months. Students can choose their own projects.
Mark Moon, 47, section head of executive and international medicine at the Mayo Clinic in Jacksonville, Florida, landed on a team composed mainly of employees of Minnetonka, Minnesota- based UnitedHealth, the largest U.S. provider of medical coverage. They chose to research how to reduce elective preterm deliveries.
The group found about a 20 percent reduction, according to preliminary results, in preterm deliveries at about 10 hospitals throughout the country where staff received education about the adverse effects of scheduling early births for mothers and babies. Extrapolating to a nationwide basis, that would mean 40,000 fewer admissions to neonatal intensive care units each year, saving the health-care system $1 billion annually, Moon said.
“If someone told me working with United would lead to a project like this in terms of better cost, I would say that I don’t see where I’m aligned with the interests of a payer,” he said in a telephone interview. “This is only the tip of the iceberg for conversations that are going to happen across what were disparate parties.”
Other groups are examining benefit packages that promote the health of Vermont residents, creating a nationwide treatment model for one of the most common lung diseases and reducing preventable blindness in India.
In addition to those from the Mayo Clinic and UnitedHealth, course materials show that the graduating class also includes an Oklahoma state senator, a New Hampshire public health official and a commander in the U.S. Navy. Milligan said the class was the “first degree program in the Ivy League to have a distance component to it.”
President Barack Obama’s health-care system overhaul that passed in 2010 has produced changes that also gave the class additional topics to discuss, Hansen said. He said that with budget cuts becoming a constant focus, his student’s last class focused on dealing with reductions in payments from Medicare, the government program for the elderly and disabled.
“This industry is constantly changing from a care, policy perspective,” Hansen said.
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