The Face of Future Health Care

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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...-care.xml?f=19


http://en.wikipedia.org/wiki/Kaiser_Permanente

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CVS to Penalize Workers Who Don't Fork Over Personal Health Information

CVS Pharmacy announced a plan to coerce employees into handing over personal health information in an effort to offset rising healthcare costs. The nationwide chain says employees have until May 1, 2014 to dish out their weight, body fat, blood pressure, glucose levels and other private details to the company—or else face a $600 annual fine.

CVS said no one from the company would see its employees’ private information. Instead, a third party will review health reports and offer recommendations to the pharmacy giant.

But others have pointed out that CVS has put its low-wage workers in a bind, forced to choose between health privacy and a hefty chunk of their salary. The $600 annual fine, or $50 a month, will hit especially hard for CVS’ low-income workforce. As Think Progress’ Annie-Rose Strasser notes:

A minimum wage worker putting in a 40-hour workweek makes about $1,160 a month. A fine of $50 a month is a huge amount for a minimum wage CVS employee to fork over … especially given the fact that American workers’ health care costs are rising while their wages are stagnating.

CVS CEO Larry Merlo’s salary increased 33 percent last year, from $12 million in 2011 to $18 million in 2012.

http://www.alternet.org/corporate-ac...ter812980&t=13

If govt did this, Fox, Repugs, etc would be screaming against it.

Let's see if any of thenm scream when a for-profit mega-corp does it.

[Agloco]

I wonder if traditionally net positive sub-specialites will ever buy into preventative medicine. It's an interesting conflict of interest for health care en ies.

[boutons_deux]

for-profit medicine will always prioritizes profit, not curing or prevention.

Even docs who give up fighting with insurers, ridiculous overheads and become salaried in hospitals are seen as patient-flipping, test- and drug-prescribing profit centers, where patients are seen as ATMs.

[Wild Cobra]

for-profit medicine will always prioritizes profit, not curing or prevention.

Even docs who give up fighting with insurers, ridiculous overheads and become salaried in hospitals are seen a patient-flipping, test- and drug-prescribing profit centers, where patients are seen as ATMs.

May sound bad, but if go bankrupt, can they still provide a service?