By Tim Bonfield
The Cincinnati Enquirer

HARTWELL - Consumers could do better jobs of taking care of themselves.

Hospitals and doctors could provide the public with better ways to compare the quality of their services.

Employers and insurers could do more to pay for the highest quality care rather than the most discounted care.

When it comes to increasing the amount of "accountability" in health care, speakers at the annual Four Forces Forecast meeting Thursday agreed that there was plenty of accountability to go around.

The health care trends conference, held at the Drake Center in Hartwell, was sponsored by the Employer Health Care Alliance and the Cincinnati Alliance for Healthcare Marketing. It featured experts in quality measurement, employee benefits and computer technology.

As health care costs rise, renewed interest has emerged in finding ways to control costs and still get the best quality.

Employers, for example, would like to route more business to the doctors and hospitals that do it right the first time.

But getting health care providers to agree on quality standards and to compare results in public has been a problem for years, said Rich Niemeyer, a former Procter & Gamble executive and a consultant with the Scheller Bradford Group.

More recently, employers have increased their efforts to change employee behavior.

By raising insurance premiums and co-payments and redesigning pharmaceutical coverage, they hope to push employees into becoming more careful health care consumers. They also are looking for ways to reward employees for healthy behavior.

"There's a complete lack of responsibility on the part of employees to take care of themselves," Niemeyer said.

But some wonder whether employers are willing to do more than talk about improving health care quality.

"We have done quality incentive projects in this community. But payers pull the plug on them," said Dr. David Mouch, president and chief executive of Medica Inc.

E-mail tbonfield@enquirer.com