Health care savings bonanza

Greenbeard

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Jun 20, 2010
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The Fiscal Times is onboard with the patient-centered medical home, a not-so-new model of primary care first outlined in broad strokes by the American Academy of Pediatrics in the late '60s that's been gaining steam and seems to be showing good results.

“We’ve had dramatic increases in quality performance, dramatic improvements in their ability to control medical cost, (and) a large reduction in emergency room utilization,” said William Runyon, the chief medical officer for Americagroup Tennessee [a Medicaid managed care company that implemented a medical home model]. “And that means ongoing high quality health care.”

Critics of President Obama’s health care reform law have dismissed the cost-saving potential of demonstration projects that tinker with the health care delivery system. Republicans running for president and on Capitol Hill have vowed to repeal the law, including its efforts at delivery system reform.

But one program expanded by the law change shows particular promise: empowering and paying primary care physicians to coordinate the care of patients with chronic conditions like heart disease, diabetes and cancer. An estimated one in five Americans, many of them poor and old and covered by either Medicaid or Medicare, has one or more of those chronic conditions. Since they account for about 75 percent of all health care costs, better coordination of their care could substantially reduce costs for the government’s Medicare and Medicaid programs, which cover most of the nation’s chronically-ill patients..

A recently completed patient survey of the chronically ill in 11 industrialized countries, which will be published in the December issue of Health Affairs, showed that poorly coordinated care is a problem almost everywhere. Medical homes or primary care offices that provided comparable services reached just 33 to 74 percent of the very sick in those countries, with the U.S. in the middle of the pack at 56 percent. But where patients did receive medical home-style care, they experienced fewer medical errors, fewer repeat operations, and were more likely to avoid the operating room entirely.

Notably, the top-ranked country was the United Kingdom, often lambasted in the U.S. press as a nation beleaguered by long lines and frustrated medical consumers. The survey found its seriously ill patients reported either the highest or second highest satisfaction ranking based on their ability to see a doctor when needed, see a doctor who knew them, and have that physician coordinate their care, which is key in that government-run system to minimizing the use of high-priced specialists.
 
empowering and paying primary care physicians to coordinate the care of patients

Actually that is what primary care has always been for. The Republican way to increase quality and reduce costs is, capitalism. It gives everyone involved the maximum incentive, day in and day out, to improve quality and lower costs. What you describe is so trivial as to be meaningless and liberal. It provides none of the long term incentives that capitalism does.
 

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