boutons_deux
03-21-2013, 01:24 PM
When people talk about the future of health care, Kaiser Permanente is often the model they have in mind.
The organization, which combines a nonprofit insurance plan with its own hospitals and clinics, is the kind of holistic health system that President Obama's health care law encourages.
Kaiser has sophisticated electronic records and computer systems that - after 10 years and $30 billion in technology spending - have led to better-coordinated patient care, another goal of the president. And because the plan is paid a fixed amount for medical care per member, there is a strong financial incentive to keep people healthy and out of the hospital, the same goal of the hundreds of accountable care organizations now being created.
"Over the course of the last 15 years, they've been just going into high gear and doing everything right," said Dr. Thomas S. Bodenheimer, a health policy expert at the University of California, San Francisco who recently chose Kaiser as his own health plan.
Yet even with all of its effort, its chairman and chief executive, George C. Halvorson, acknowledges Kaiser has yet to achieve the holy grail of delivering that care at a low enough cost. He says he and other health systems must fundamentally rethink what they do or risk having cost controls imposed on them either by the government or by employers, who are absorbing the bulk of health insurance costs. "We think the future of health care is going to be rationing or re-engineering," he said.
Mr. Halvorson is convinced that Kaiser's improvements in the quality of care save money. But he also says that the way to get costs lower is to move care farther and farther from the hospital setting - and even out of doctors' offices. Kaiser is experimenting with ways to provide care at home or over the Internet, without the need for a physical office visit at all. He also argues that lower costs are going to be about finding ways to get people to take more responsibility for their health - for losing weight, for example, or bringing their blood pressure down.
"The obesity work is incredibly difficult," he said. "It's very, very hard to move the needle."
The organization, with some $50 billion in annual revenue, owns 37 hospitals and employs 17,000 doctors, all on salary. And its integrated model is in favor again. Hospitals across the country are buying physician practices or partnering with doctors and health insurers to form accountable care organizations, or A. C.O.'s, as a way of controlling more aspects of patient care. Doctors are also creating so-called medical homes, where patient care is better coordinated.
The days when doctors, hospitals and other providers are paid separately for each procedure will disappear eventually, health experts say. Instead, providers will have financial incentives to encourage them to keep people healthy, including lump sums to care for patients or provide comprehensive care for a specific condition. "All of care is going to move down this path, and it has to," Mr. Halvorson said. "Medical homes are doing it; the very best A. C.O's are going to figure out how to do it."
http://mobile.nytimes.com/2013/03/21/business/kaiser-permanente-is-seen-as-face-of-future-health-care.xml?f=19
http://en.wikipedia.org/wiki/Kaiser_Permanente
The organization, which combines a nonprofit insurance plan with its own hospitals and clinics, is the kind of holistic health system that President Obama's health care law encourages.
Kaiser has sophisticated electronic records and computer systems that - after 10 years and $30 billion in technology spending - have led to better-coordinated patient care, another goal of the president. And because the plan is paid a fixed amount for medical care per member, there is a strong financial incentive to keep people healthy and out of the hospital, the same goal of the hundreds of accountable care organizations now being created.
"Over the course of the last 15 years, they've been just going into high gear and doing everything right," said Dr. Thomas S. Bodenheimer, a health policy expert at the University of California, San Francisco who recently chose Kaiser as his own health plan.
Yet even with all of its effort, its chairman and chief executive, George C. Halvorson, acknowledges Kaiser has yet to achieve the holy grail of delivering that care at a low enough cost. He says he and other health systems must fundamentally rethink what they do or risk having cost controls imposed on them either by the government or by employers, who are absorbing the bulk of health insurance costs. "We think the future of health care is going to be rationing or re-engineering," he said.
Mr. Halvorson is convinced that Kaiser's improvements in the quality of care save money. But he also says that the way to get costs lower is to move care farther and farther from the hospital setting - and even out of doctors' offices. Kaiser is experimenting with ways to provide care at home or over the Internet, without the need for a physical office visit at all. He also argues that lower costs are going to be about finding ways to get people to take more responsibility for their health - for losing weight, for example, or bringing their blood pressure down.
"The obesity work is incredibly difficult," he said. "It's very, very hard to move the needle."
The organization, with some $50 billion in annual revenue, owns 37 hospitals and employs 17,000 doctors, all on salary. And its integrated model is in favor again. Hospitals across the country are buying physician practices or partnering with doctors and health insurers to form accountable care organizations, or A. C.O.'s, as a way of controlling more aspects of patient care. Doctors are also creating so-called medical homes, where patient care is better coordinated.
The days when doctors, hospitals and other providers are paid separately for each procedure will disappear eventually, health experts say. Instead, providers will have financial incentives to encourage them to keep people healthy, including lump sums to care for patients or provide comprehensive care for a specific condition. "All of care is going to move down this path, and it has to," Mr. Halvorson said. "Medical homes are doing it; the very best A. C.O's are going to figure out how to do it."
http://mobile.nytimes.com/2013/03/21/business/kaiser-permanente-is-seen-as-face-of-future-health-care.xml?f=19
http://en.wikipedia.org/wiki/Kaiser_Permanente