With health care having found its place in the budget, the reform discussion is shifting gears from a focus on broad principles to specific proposals. When it comes to financing health reform, President Obama and other lawmakers have made it clear that every option is on the table.

George Halvorson, the CEO of Kaiser Permanente, hopes they'll take a long hard look at the potential savings from improving the way care is delivered. Noting numerous studies showing the potential to save 25 to 30 percent from our current system through quality improvements, Halvorson told attendees at an Alliance for Health Reform briefing (transcript and video here) last week:

What we have in front of us is an opportunity to save a huge amount of money in American health care by getting care right. This isn't by rationing. This isn't by denying care. This isn't by shifting cost. It is just from getting care right.

The LA Times has a nice profile of on some of the ways Kaiser Permanente seems to be getting care right, placing the system's model of integrated care in the context of our current health reform debate. Our colleague Joanne Kenen posted recently on some real-world examples innovations and improvements in the treatment of chronic disease.

Today, we'd like to highlight some of the successes presented at the Alliance briefing of how organizations have been able to improve quality through an emphasis on collaboration and coordination.

Montefiore Medical Center in New York, a delivery system based in the Bronx, providing nearly 85,000 in-patient stays, and 1.1 million office visits annually. Maria Castaneda, the Secretary-Treasurer of 1199SEIU, which represents Montefiore's health care workers, emphasized "labor—management initiatives that improve quality patient care, patient safety, and patient satisfaction." Montefiore's Quality Officer, Rohit Bhalla, MD, , discussed how that emphasis on collaboration among all the staff, doctors, nurses, technicians and other health care workers, had led to measurable improvements in patient outcomes and satisfaction. A more inclusive rounding program to check on patient needs has reduced Montefiore's fall rate by 30 percent, and a hygiene program has reduced infections. Montefiore's health IT system has also helped the organizations register, monitor, and ultimately try  to manage health disparities.

Kaiser Permanente Colorado's Collaborative Cardiac Care Service (CCCS) uses Kaiser's electronic care registry to facilitate a team-based approach to cardiac care, bringing clinicians from across departments to help manage and treat heart disease. We had the privilege of sitting down with Jon Rasmussen, chief of clinical pharmacy cardiovascular services at Kaiser Permanente Colorado, to discuss the program in more detail after the event. The video of interview is available below (please excuse some of the production value on our flip cam—we were told "mumblecore" is big right now.) and here are some of the highlights from what Rasmussen had to tell us:

• Process Improvements: CCCS has improved performance on process measures of care proven to be important to managing cardiac disease. For example, before the program just over a quarter of patients met their cholestrol goals. After the program, 73 percent of patients did.
• Outcomes: For patients who have suffered a heart attack, any participation in CCCS, whether it's a month after or three years later, has been shown to reduce overall mortality by 76 percent. Early intervention by CCCS (less than 90 days after an event) reduced overall mortality by nearly 90 percent.
• Efficiency: Early estimates suggest the program saves Kaiser Permanente at least $3 million annually and a study to be released later this year, Rasmussen said, would show significantly higher savings.