Health Care:

Rochester's Community Approach Yields Better Access, Lower Costs

HRD-93-44: Published: Jan 29, 1993. Publicly Released: Mar 5, 1993.

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Pursuant to a congressional request, GAO reviewed the health care system in Rochester, New York, which has lower health care costs per capita and provides health insurance to a larger proportion of its residents than the nation as a whole.

GAO found that: (1) in 1991, health insurance costs per employee in Rochester were 33 percent lower than national health care costs; (2) Rochester's hospital costs in 1990 were lower than national costs; (3) Rochester residents were more likely to have health insurance coverage than the rest of the nation; (4) between 1989 and 1991, the uninsured accounted for 7.1 percent of the population in Rochester, compared to 13.7 percent in the nation; (5) residents of Rochester expressed greater satisfaction with their health care system than the general U.S. population and indicated that they had less difficulty in obtaining care than residents in other areas; (6) Rochester's health care system is distinguished by the interaction of several factors, primarily a long history of community-based health planning; (7) Rochester's planning initiatives have included limiting the expansion of hospital capacity, implementing an experiment of global budgeting that caps total hospital revenues for several years, and controlling the diffusion of medical technology; and (8) initiatives have benefited from the active support of Rochester's employers, who have worked with insurers, providers, and government representatives to try to control health care costs and improve access to care.

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