Study examines how doctors and patients see health care

WASHINGTON -- Doctors and patients agree on many of the key issues facing the future of health care, a study to be released today shows, but that's where much of the agreement ends.

Doctors believe patients receive the preventive care they need about half the time; patients, meanwhile, believe they receive such about one-third of the time.

About 60% of doctors believe the quality of care varies wildly even within their local areas. And only 26% of patients and half of hospital executives think their health care systems are on a path to being more cost-efficient and accountable.

"I think there's pretty wide agreement that, overall, the nation is not getting a good value for the $2.6 trillion that will be spent in health care this year," said Simon Stevens, who co-chairs the Optum Institute for Sustainable Health, which commissioned the survey. The institute launches today as a new think tank looking at health care issues. It's funded by OptumHealth, OptumInsight and OptumRx, which provide health management, technology and prescriptions.

Patients don't know enough about health care, the researchers found, so they can't make good decisions about how to purchase it, Stevens said.

Electronic health records that patients can see and clear pricing information about medical procedures will help fix the problem, Stevens said.

Consumers believe health care costs could be cut by 29% without affecting its quality, while doctors put it closer to 14%, according to the survey.

"Patients were much more bullish about the extent to which you can take costs out without impacting care," Stevens said. "Even so, 14% would be a huge victory for cutting health care costs."

Less than half — 46% — of the surveyed doctors said they have electronic records, but 90% expect to have them within three years.

Many of those physicians, however, said they were not ready for the transition to electronic records, Stevens said. That does not surprise Robert Tennant, senior policy adviser for Medical Group Management Association, a trade group.

"Some physicians don't type," Tennant said.

Also, Tennant said, there are more than 1,000 electronic health record systems to choose from and the systems are expensive. Government aid provided by the 2009 American Recovery and Reinvestment Act, as well as incentives for Medicare providers who use electronic records, have helped cut those costs, he said.

Eventually, doctors will need to make the change to get paid. Stevens said that while doctors expect their pay will be linked to performance, 49% say they are "not at all prepared for this shift," and 40% of hospital executives said more than a quarter of revenue would be at risk.

Tennant said doctors will have to report performance measures to receive performance bonuses. "It's easier to do that with an electronic health record," he said.

The poll, conducted by Harris Interactive, surveyed 1,000 physicians, 400 hospital executives and 2,000 patients.