The authors point out that while blood pressure should be less than 140/90 , LDL cholesterol less than 100 in persons with a history of heart attack and A1c should be less than 7% in persons with diabetes, it's clear that the cure can be more costly than the disease.
As a result, they call for measuring and rewarding quality based on accountable prescribing that not only measures the numbers (blood pressure, blood cholesterol or diabetes control), but the percent of individuals receiving conservative or first line treatments. While this approach would require an even more detailed databases/registries, it's within reach of most commercial insurers and advanced electronic record systems. We owe it to our patients to provide a tailored, bottom-up, nuanced and Ver. 2. approach to measuring health care quality.
It's also a concept that the population health and care management service providers could, with the right kind of clinical partners, lead. This calls for a pilot program and, in the DMCB's humble opinion, the sooner, the better.
For a better idea of how this might work, check out this table .