A new study shows Iowa hospitals are the best in the nation for controlling costs without diminishing care, and Mahaska Health Partnership in Oskaloosa ranked near the top of the list of hospitals in the state.

In the national study by Dartmouth College, titled, “Tracking the Care of Patients with Severe Chronic Illness,” researchers conclude that the quality of care for Americans with chronic disease is remarkably uneven. Authors of the study found that most patients receive episodic care (based on when they get sick and what has made them ill) from multiple physicians who rarely coordinate the services they deliver. This can result in conflicting treatment or a duplication of tests and procedures performed.

Medicare spent an average of $39,243 per chronically ill patient for end-of-life care in Iowa, the lowest in the nation and more than 30 percent below the national average of $52,838. All hospitals in Iowa fall below the national average, and MHP is the fifth lowest in the state at $32,128. Meanwhile, New Jersey, the highest-cost state, spent $66,770 per patient — 70 percent more than Iowa.

“Medicare must prioritize becoming a real purchaser of value, the kind of value Iowa hospitals provide and that is clearly documented in the Dartmouth research,” said Kirk Norris, president/CEO of the Iowa Hospital Association.

The IHA has pressed Congress and the Centers for Medicare & Medicaid Services to initiate policies that address the study’s findings. “Medicare is the nation’s largest health care consumer, and like any other American consumer, it should demand and reward low cost and high quality — exactly the value Medicare gets from Iowa,” Norris concluded.

Authors of the study blamed current Medicare payment policies for causing wide variation in care and wasting resources.

“Probably the most important driver of how healthcare resources are established and used is the current reimbursement system,” the authors wrote. “Hospitals and doctors are paid for activities, hospitalizations, procedures, tests — and are economically punished for using less-invasive, less-costly strategies of care.

“In an environment where healthcare costs are under great scrutiny, we are pleased that our numbers are among the lowest in the nation,” said MHP Chief Executive Officer Jay Christensen. “As a healthcare organization, we strive to provide the highest quality of care at the most cost-effective level.”

Christensen credits a team effort at MHP that emphasizes communication and collaboration among all healthcare providers. He said local physicians are extremely supportive of the hospital’s efforts because they too, want what’s best for their patients.

“Our common goal is to avoid excessive medical testing and care that will not positively impact the patient’s outcome,” Christensen explained. “We focus on activities that provide a survival benefit, such as better control of the patient’s blood pressure.

“When it comes to healthcare services, we believe quality of life is an important factor. Our outstanding hospice services provide another opportunity to care for terminally-ill patients with respect and dignity, where patients and family members have a strong voice in the care they receive.”

Christensen is the current chairman of the IHA, a voluntary membership organization representing hospital and health system interests to business, government and consumer audiences. All of Iowa’s 117 community hospitals are IHA members.

“We knew we provided great value in Iowa, and it’s refreshing to see another data source that substantiates that,” Christensen said.