WASHINGTON — The Sabres didn't make it very far in the playoffs, and let's not

talk about the Bills, but the Buffalo area is increasingly being seen as a national leader in

something that matters much more to every person here: health care.

A delegation from Buffalo, including leaders of its two major hospital systems, two leading

insurers and others, was among of 15 groups invited last week to a Washington, D.C., seminar

on local innovations for improving health care while controlling costs.

Days earlier, the head of a local group of Catholic physicians was invited to Washington to

co-chair a similar event.

And it's all because Buffalo insurers and health care providers initiated reform on their

own years ago, long before Congress got around to it.

The Institute for Healthcare Improvement invited the Buffalo team to the seminar to discuss

its collaboration on electronic medical records and other innovations, said Carol L. Beasley,

the institute's director of strategic projects.

"The kind of drive they've shown makes us interested," Beasley said of those involved in

the Buffalo efforts. "They've been working hard. They're not complacent."

That's for sure.

At the seminar, Dr. Michael W. Cropp, president and chief executive officer of Independent

Health, outlined the efforts the area's insurers and hospitals had already made to cut costs

by working together.

And he set an ambitious goal: holding increases in local health care costs —

currently running at a double-digit rate each year — to the low-single-digit rate of

general price increases by 2017.

Meanwhile, a group of health care leaders from Rochester spelled out how it worked with the

University of Rochester to make the local health system more efficient. Speakers from

Portland, Maine, to Bend, Ore., also spelled out reform efforts they undertook years before

Congress finalized a health care reform package in March.

The new law provides incentives for local experiments aimed at putting the brakes on health

care inflation while delivering better care and health.

Health care experts call that the "triple aim."

Atul Gawande, a renowned Harvard University medical professor whose New Yorker magazine

articles played a key role in the health care debate, said that the participants might provide

the answers.

"If there is going to be a community that achieves the triple aim and becomes a national

model, it's going to be [a community that is] here," Gawande said at the seminar.

In Buffalo, the effort to improve health care while controlling costs is playing out in

several ways.

Most prominently, local insurers and medical providers teamed up years ago to form

HEALTHeLINK, an electronic network that links patients, doctors and insurers so they can

easily share medical records — and thus avoid costly duplicate paperwork and tests.

HEALTHeLINK recently received a $16.1 million federal stimulus grant to take that effort even

further.

"This is a recognition of what we have done," said Daniel E. Porreca, executive director of

HEALTHeLINK.

Beyond that, the Buffalo delegation touted the P2 Collaborative, an effort to talk up

healthy lifestyles while making health care more widely available and efficient.

"What we're seeing in Buffalo is that we're finding ways to work together," Cropp said

after his presentation. "A lot of communities are just sitting back and waiting."

One reason Buffalo has been moving forward, the health leaders said, is that it's a poorer

community that can't afford to do otherwise.

Perhaps more important, though, its top insurers and hospital systems are all locally based

nonprofits.

"That fact has allowed collaboration to occur to an extent where it wouldn't otherwise,"

said Dr. Raghu Ram, senior medical director at BlueCross BlueShield of Western New York.

Elsewhere, it's not uncommon for for-profit, out-of-town hospital companies and insurers to

dominate the market — and focus on competing for dollars rather than finding savings.

In Buffalo, the efforts at collaboration reach all the way down to the doctor level. In

fact, Dennis R. Horrigan, president of the Catholic Independent Practice Association,

discussed those efforts on a panel sponsored last week by the World Congress, another

nonprofit group working toward improving the health care system.

That conference focused on "accountable-care organizations" — which link physicians

and other medical providers in networks where their pay is determined by the quality of the

care they provide, not the number of patients they see or tests they perform.

Horrigan's group is in the process of setting up an accountable-care organization, he said.

"Organizations that are here are demonstrating their readiness" for the national health

care overhaul's push for accountable care, Horrigan said.

"Basically, the health bill tells Medicare providers: Get organized and get accountable,

and we will help you set it up," Horrigan said. "Otherwise, we're just going to slash your

reimbursements."

Such cost-cutting moves are largely aimed at communities such as Miami and McAllen, Texas,

where Medicare spends nearly twice as much money per patient as it does in Buffalo.

While "bending the curve" of cost increases is a key goal of health care reform, the local

experts note that thanks to homegrown reform efforts, the curve is already starting to bend in

Buffalo.

Medicare spent $7,637 for each patient in Buffalo in 2007 — $1,044 less than the

national average, according to the Dartmouth Atlas of Health Care.

From 2002 to 2007, local Medicare costs rose by 26.43 percent — 5 percentage points

less than the nationwide figure.

In other words, health care reform has already begun to take hold in Buffalo, creating a

relatively low-cost asset that the community can use to lure prospective employers, as well as

a thriving health care industry that is creating jobs on its own.

"This is going to create an economic platform for success for our community," Cropp said of

the reforms that are progressing in Buffalo.

Then again, some hard facts could complicate matters and send local health care costs

soaring, according to the Buffalo health care experts who visited Washington.

There's a shortage of primary-care doctors and a proliferation of MRI centers that could

lead to unnecessary tests, they said. Moreover, the community is an older one, and lifestyle

factors — think wings and the Friday night fish fry — lead to higher-than-average

rates of heart disease.

Still, the local health care experts said they think Buffalo's system is in far better

shape than those in many other communities, where medicine is commerce and costs are out of

control.

Dr. Irene S. Snow, medical director of Buffalo Medical Group, said, "It's nice to know that

in Buffalo, something is actually going right."