Better, Faster, More Affordable
EDITOR’S NOTE: In 2004, Dr. Donald Storey, then the senior medical director of the Aetna Aexcel Performance Networks, conveyed unsettling news to Dr. Robert Mecklenburg and his physician colleagues at Virginia Mason Medical Center. Dr. Storey said that Virginia Mason could be excluded from an important Aetna network based on high costs for certain services. Dr. Mecklenburg and his colleagues had just collided head-on with the realities of the marketplace—that companies represented by Aetna (Starbucks, Costco, Alaska Airlines and many others) faced intense competitive pressure and needed to find high-quality, affordable care for their employees. Many doctors would have lamented this news from Aetna, but Mecklenburg, then chief of medicine at Virginia Mason, saw it as an opportunity to apply the Virginia Mason Production System (VMPS) to better align care with the needs of the marketplace. VMPS was an adaptation of the Toyota Production System, which had helped Virginia Mason eliminate waste and provide better, safer care for patients. Mecklenburg believed the system could serve the needs of companies as effectively as it served the needs of patients. Thus did Mecklenburg and others create Marketplace Collaboratives, in which teams worked to provide efficient, high-quality care at the lowest possible price. The teams addressed a variety of issues with a number of companies. This excerpt from Transforming Health Care: Virginia Mason Medical Center’s Pursuit of the Perfect Patient Experience focuses on the work Virginia Mason did with Starbucks concerning back pain.
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After receiving the news from Dr. Storey, Dr. Mecklenburg called then Starbucks benefits manager Annette King and asked whether he could come by and see her. She was somewhat taken aback, for she generally only heard from providers when they were seeking higher payments. The chief of medicine at a major medical center calling to request a meeting for how he might better serve her employees—now that was unheard of. “I never had anybody come and say, ‘We want you to work with us on how we care for your employees,’” says King.
King told Mecklenburg she had a real issue with back pain among her employees and asked Mecklenburg to work on a plan to improve quality and reduce cost. “I could hardly believe it,” Mecklenburg says. “Who would imagine that back pain was anything to get very excited about, and yet there it was: Large numbers of affected employees and a very high aggregate cost.”
Mecklenburg learned that the cost burdens for
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