Source: How Intermountain Trimmed Health Care Costs (Health Affairs, 2011)

Summary

The paper in which Intermountain's own quality leadership — Brent C. James and Lucy A. Savitz, both then at Intermountain Healthcare in Salt Lake City — set out the method behind the health system's clinical quality-improvement program and its cost claim, in a peer-reviewed policy journal rather than in a press release. Health Affairs 30(6):1185–1191, June 2011; DOI 10.1377/hlthaff.2011.0358; PubMed 21596758.

It is the load-bearing citation for the wiki's claim that Intermountain applied industrial process management to care delivery from the late 1980s onward, and for the specific mechanism it used: measure clinician-level variation, understand it, then manage it, on the Deming premise that the cheapest care is the highest-quality care.

Useful Claims

• The program dates to 1988, when Intermountain began applying W. Edwards Deming's process management theory to health care delivery — the paper's own dating of the work, and the reason the wiki describes this as a late-1980s beginning.
• The stated mechanism is variation management: savings came from "measuring, understanding, and managing variation among clinicians in providing care," supported by data systems and management structures built to increase accountability.
• The paper's worked example is obstetric: a new delivery protocol reduced rates of elective induced labor, unplanned cesarean sections, and newborn-intensive-care admissions.
• That single protocol is claimed to save an estimated $50 million in Utah each year, and about $3.5 billion annually if applied nationally. Both are the authors' estimates, not audited figures — see Reliability Notes.
• The framing is national policy, not local operations: the authors present "organized care" as potentially central to containing the cost growth that could undermine coverage expansion under the Affordable Care Act.

Verbatim

The published abstract, quoted exactly:

Since 1988 Intermountain Healthcare has applied to health care delivery the insights of W. Edwards Deming's process management theory, which says that the best way to reduce costs is to improve quality. Intermountain achieved such quality-based savings through measuring, understanding, and managing variation among clinicians in providing care. Intermountain created data systems and management structures that increased accountability, drove improvement, and produced savings.

— Abstract

For example, a new delivery protocol helped reduce rates of elective induced labor, unplanned cesarean sections, and admissions to newborn intensive care units. That one protocol saves an estimated $50 million in Utah each year. If applied nationally, it would save about $3.5 billion.

— Abstract

Reliability Notes

Primary tier: a peer-reviewed article, cited by DOI, retrievable by that DOI regardless of what happens to any publisher URL. That is why this page carries no archive snapshot.

Three cautions, and they matter more than usual here. The authors are the program's owners. James and Savitz ran the work they are evaluating; the paper is a credible insider account of method and an interested party's account of results. The savings figures are estimates, and the paper says so — "an estimated $50 million," "about $3.5 billion" — extrapolated from one protocol, not measured against a control arm. Repeat them as the authors' estimate, attributed and dated, never as an audited number. The full text is paywalled, so the claims above are limited to what the published abstract carries; anything from the body of the paper needs a legitimately obtained copy before it is quoted here.

One detail the wiki asserts is not in this abstract: the 1996 extension of "active management" to prioritized clinical processes, and the count of processes brought under it. The abstract dates the program to 1988 and does not enumerate processes, so that claim still needs its own citation.

Related Pages

• Intermountain Clinical Quality Improvement
• Source: Integrated Team-Based Care at Intermountain (JAMA, 2016)
• Source: Intermountain Health (Wikipedia)