Briefing Paper: Health Care Innovators and Health Care Reform

Executive Summary

Over the past year, politicians of all stripes, academics, think tanks, and journalists have engaged in a vigorous debate over whether health reform legislation before Congress will truly rein in skyrocketing costs.  Reform proponents have pointed to quality leaders like Mayo Clinic and Intermountain Health, while opponents have questioned whether these successes can be replicated.  But these health care leaders are not the only models for reform or test of reform’s potential to reduce costs and improve quality. Hundreds of other health care innovators have blazed paths toward high-value care in their own communities. In addition to national leaders like Mayo, a myriad of hospitals, health centers, provider groups, businesses, and community coalitions have pioneered cost-saving, quality-enhancing initiatives like chronic disease management, health IT, quality initiatives, bundled payments, evidence-based medicine, and new approaches to care coordination.

U.S. Public Interest Research Group (U.S. PIRG) researchers have contacted health care innovators throughout the Midwest.  The accounts below were developed based on interviews with the leaders who have helped drive successful reform initiatives.  After each case study, we explore the provisions of health reform legislation before Congress that would encourage or replicate that reform. 

Each of the case studies below demonstrates an innovative approach to delivering quality health care at a lower cost. In each case, we find these models of care could be scaled up significantly through provisions already included in the health care bills before Congress.