In our conversation, Serota recalled that when he was in private practice, his insured patients got colon screenings "and it did reduce the incidence of colon cancer in my population, at an incredible cost."
"At a much lower cost we can be immunizing people in the inner city, and doing other things for them, such as feeding them or housing them at a much lower cost," he says.
Alta Med has a substantial investment in IT, but officials wonder if the group is tracking the proper quality metrics to improve their patient population, Serota says.
"We had to build a quality department, to collect data and build the informatics infrastructure," Serota told me. "We run a skinny margin" in profitability, he adds. "If we are going to spend that much money, we want to go for the right things for the right reasons," Serota says. "That's the biggest issue."
In his JAMA report, Serota and other authors call for a "new platform" to address quality measurement that they say is more "outcomes-based, simple and adaptable to local circumstances" than existing measures.
While patient satisfaction scores should be maintained, significant changes for the government's quality metrics would be fairer to safety net hospitals, Serota wrote.