Media reports have it that we will soon see the decision on the Affordable Care Act (the health reform law) from the U.S. Supreme Court any day now.  I say next week, June 28.  Just my predication, because that way all the Justices will leave for summer vacation immediately afterward.  A scientific analysis?  No.

This evening I saw the film Moneyball, starring Brad Pitt and Jonah Hill.  What a great movie!  But it did trigger some thoughts.  Billy Beane was looking for on-base percentages, which would ultimately turn into runs or, at least, that was the statistic that yielded the most runs (as I understand it, and I am happy to be corrected).  In conducting surgical or other health care procedures, whether in hospitals or physicians’ offices, it stands to reason that building a statistical basis for error-free performance should be the norm.  Checklists and statistical data need to employed.  While there will always be cases with strange outliers, those cases are simply not the norm.  Building the tools that will provide this information, however, will take a concerted effort from all - health care providers and public and private payors included - to pool and share (de-identified) outcome and procedure-based data.

My reading this week has presented two somewhat conflicting stories.  One story concerns a nationwide quality collaboration that “has saved an estimated 24,820 lives and reduced health care spending by nearly $4.5 billion in the first three years” of its enactment.  In this collaborative model, 157 hospitals in 31 states share data and “define a common framework” using consistent measures between them.   So far, so good.

The other story comes out of a Government Accountability Office report issued on January 13.  The GAO found that the U.S. Department of Health and Human Services has not yet prioritized the development of quality measures, and, HHS’s National Quality Forum, a non-profit, “consensus-based group of health experts hired by HHS,” has not followed deadlines, which may result in missing other crucial deadlines in the Accountable Care Act.  This may result in delays in enacting programs under health care reform to control health care costs.

What is the difference?  Perhaps, human nature being what it is, timetables need to be followed, with repercussions if they are not.