If there were a way to save $207.4 million, avoid 30,000 unnecessary hospitalizations and more than 2,000 premature deaths, we’d jump at it, right?
That’s what Missouri would gain if its health system performed as well as the systems in Vermont, Hawaii, Iowa and Minnesota. Illinois has even more at stake. It could save $576 million, avoid 70,000 unnecessary hospitalizations and nearly 5,000 premature deaths.
Most of us like to believe that the quality of care we receive is second to none. But a comprehensive new report from the Commonwealth Fund, a nonpartisan foundation focused on improving health quality, shows significant opportunities for improvement.
The report ranked Missouri in the bottom half of states on health system performance, 36th overall. That’s a drop of five places since an earlier study was published in 2007.
Illinois did even worse, falling to 42nd in the current ranking from 32nd place in 2007.

The sheer size of state health care systems can make it seem as if improving quality is an overwhelming impossibility.
Those systems operate with both private and public components. They are subject to decisions made independently each day by thousands of people — doctors, nurses, hospital administrators, insurance executives and patients.
But the Commonwealth Fund report shows that improvements are possible. In fact, some already have occurred. That’s especially true for measures in which doctors, hospitals, insurance companies and state governments have committed to reporting results and improving quality.
For example, one area of special emphasis in recent years has been making sure that patients admitted to hospitals for heart attack, heart failure or pneumonia get recommended treatments. Not special treatments or novel treatments — just recommended treatments.
In 2007, just 84.4 percent of patients nationwide got them. In 2009, the worst-performing state beat that average. The best-performing states provided recommended care more than 95 percent of the time.

There are plenty of simple steps that Missouri doctors and hospitals could take now to improve quality and reduce costs. Among them:
• Ensure that adults over age 50 get all recommended screenings and preventive care. In Missouri, the number who receive those tests and treatments is 20 percent below the average of the best-performing states.
•  Immunize children with five key vaccines. The percentage of Missouri children who get those vaccinations is 30 percent below the average of the best-performing states.
•  Reduce hospital admissions for children with asthma by providing more kids with care and better coordinating those treatments. In Missouri, the hospital admission rate for childhood asthma is 163 percent higher than the average for the top five best-performing states.

Deaths from preventable illness and infant mortality rates here are 50 percent higher than in the best-performing states. Death rates from breast cancer are 43.5 percent higher.
But Missouri already has taken some important steps to improve quality. Among them is the state’s new Time Critical Diagnosis System for heart attack and stroke patients.
That system, which still is under development, was created by a new law last year. It’s designed to quickly identify patients who are having heart attacks and strokes and to speed them to hospitals that are best equipped to help them.
Simple? Perhaps, but it has the potential to dramatically improve the quality of care critically ill patients receive. The system could demonstrate that simple steps can produce big improvements in health care, saving millions of dollars and thousands of lives.