By Michael Ollove
Several years ago, a California study showed that a half-dozen elective surgeries were being performed far more often in Humboldt County than they were in the rest of the state.
The procedures included hip and knee replacements, hysterectomies and carotid endarterectomies, a surgery to remove plaque buildup in the carotid arteries.
Geographical variation in the delivery of health care can harm patients and increase costs. That is especially true when it comes to surgery, which is usually more expensive and riskier than less invasive treatments.
Medicaid makes up a huge portion of state budgets, so the issue of health care variation is a pressing one for states looking to hold down costs.
In Humboldt County, doctors, hospitals, and others involved in health care wondered why surgeons in their area operated so often, and if they could do anything to get closer to the state norms.
To find out, they launched the Humboldt County Surgical Rate Project, which brought together doctors, health-care advocates, community organizations, unions, colleges and small employers.
As it turned out, a large part of “what was actually happening out there” was surprisingly simple . . .
“We weren’t trying to identify anyone as a ‘bad guy,’” said Betsy Stapleton, a retired nurse practitioner who is the co-director of the Humboldt County Surgical Rate Project. “The idea was to identify what was actually happening out there and to figure out ways to address it. It led to really fascinating conversations.”
As it turned out, a large part of “what was actually happening out there” was surprisingly simple: Patients in Humboldt County weren’t playing a big enough part in their own health care decisions. Continue reading