UT MD Anderson Article Offers One Roadmap for Defining Value in Health Care, Earns National Award from Leading Journal

MD Anderson News Release 02/02/12

A team from The University of Texas MD Anderson Cancer Center is receiving a national award for a research article tackling a question vital to the future of health care with reform regulations looming, competition growing and costs rising.

The MD Anderson study took on the complex question of defining value in health care and for its paper that outlines one approach, the team has been awarded the 2012 Edgar C. Hayhow Article of the Year Award.

Presented by the American College of Healthcare Executives (ACHE), the winning paper appeared in the organization's publication, the Journal of Healthcare Management, in the November/December 2010 issue. The Hayhow Award was created in 1959 as a tribute to the organization's 14th chair and the first practicing administrator to earn a doctoral degree. The award will be presented in March at the ACHE's annual Congress on Healthcare Leadership in Chicago.

"The medical community understands how fundamental the concept of value is to improve the quality and delivery of care because it impacts patients, hospitals, physicians, insurance providers and regulators," said Thomas W. Feeley, M.D., professor and head of the Division of Anesthesiology and Critical Care and the corresponding author of the study. "We've been looking at this complex question for many years and our paper outlines an approach that has been successful at MD Anderson and one that, we believe, can be applied throughout our institution. While we don't assert that this approach will work for everyone, we think it's important information to advance the national conversation."

The study details MD Anderson's method of testing the value proposition first described in 2006 by Professor Michael Porter of the Harvard Business School and his collaborator, Elizabeth Teisberg, and defines and measures outcomes and costs in a set of three specific head and neck cancers. It was Porter who first described value in health care as the balance between patient outcomes and costs.  

With the Head and Neck Center as its clinical "lab," the research team studied more than 2,400 patients diagnosed with cancers of the larynx, throat and mouth, and gathered data and costs to define quality in that single setting. Researchers looked at patient survival, the time it took for patients to go through treatment and return to work, and quality of life issues such as swallowing and speaking. The team then analyzed the costs of care based on the diagnosis and stage of disease and found, not surprisingly, that the majority of costs were incurred during treatment.

The model used in the Head and Neck Center for establishing outcomes and defining quality is one that the MD Anderson team believes can be replicated in other clinical areas, though each center will have its own outcomes. For example, while swallowing and eating are important measures for patients with head and neck cancer, for breast cancer survivors, the leading outcomes may be the cosmetic result of treatment and hormonal health.

The study also points out that the true measure of the value proposition lies in a patient's ability to access accurate and useful information about a provider's outcomes, costs and experience. As a result, researchers urge providers to seek patient feedback and learn what information is most valuable when making health care decisions.

In addition, the study notes the need for electronic medical records to better integrate and pull key information and a time-driven, activity-based cost accounting system that will detail true costs of treatment for specific conditions and diagnoses.

The team honored for the outstanding article includes Feeley; Heidi Albright, director, Institute for Cancer Care Excellence; Ronald Walters, MD, MBA, associate vice president for Medical Operations and Informatics and professor in the Department of Breast Medical Oncology; and Thomas W. Burke, MD, executive vice president and physician in chief and professor in the Department of Gynecologic Oncology and Reproductive Medicine.

These four people also form the leadership core of MD Anderson's Institute for Cancer Care Excellence, a collaborative group that focuses its study on cancer economics, patient safety and quality improvement, information technology, education and outreach development. The institute recently launched initiatives to explore ways to eliminate waste, reduce costs and quantify quality care.