TABLE 20-1Potential Savings from Optimization of Cost and Quality

AreaDomainPotential
PriceEfficiencyQualityCost (% of TMC)Quality
LaboratoryX0.75–1.25Neutral
Hi-tech imaging—CT, MRI, PET
Lowest-cost facility within 15 miles
X0.5–1.5Neutral
Ambulatory surgery—16 procedures
Lowest-cost facility within 15 miles
X0.5–1Neutral
Pharmacy
Optimal use of therapeutically equivalent generics
X3.0–5Neutral
Hospital—9 procedures
Top 33% of facilities
XX0.5–1>30% reduced mortality and complication rate
Specialty physicians
21 specialties, top 33%
XX8–125% improved EBM adherence; >20% reduction in readmission rates

NOTE: CT = computer-assisted tomography; EBM = evidence-based medicine; MRI = magnetic resonance imaging; PET = positron emission tomography; TMC = total medical cost.

From: 20, Consumers-Directed Policies

Cover of The Healthcare Imperative
The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary.
Institute of Medicine (US) Roundtable on Evidence-Based Medicine; Yong PL, Saunders RS, Olsen LA, editors.
Washington (DC): National Academies Press (US); 2010.
Copyright © 2010, National Academy of Sciences.

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