Shift in Health-Cost Focus Is Said to Show Promise

[NRSKarenRN, BSN, RN]

from the ny times:

shift in health-cost focus is said to show promise

by [color=#004276]reed abelson

published: july 12, 2007

by coordinating care and keeping their patients out of the hospital, doctors can help reduce overall health care spending, medicare officials said yesterday in announcing the results of an experiment that allowed doctors to share in the cost savings.

the experiment, which started in april 2005 and is to continue through april 2008, is an attempt by medicare to rethink the way it reimburses doctors. the goal is to pay them for the quality of the care they deliver, rather than on how many tests and procedures they perform....

....although there are sharp limits to the conclusions that can be drawn, medicare officials and the doctor groups involved say the experiment shows the potential in encouraging doctors to provide care and counseling programs that help patients stay out of the hospital or emergency room by better managing chronic conditions like [color=#004276]diabetes or [color=#004276]heart disease. "it's where the medicare program has to go," mr. kuhn said.

while all of the 10 physician groups participating in the experiment improved their care for patients during the first year, according to the measurements in place, only two earned bonus payments...

other successful measures include simple follow-up. the university of michigan group is having a nurse or nursing assistant call patients who have been discharged from the hospital or emergency room within 24 hours, making sure they understand the drugs they need to take or that, for example, a visiting nurse came as scheduled...

as a 20yr+ homecare veteran, follow-up call post hospitalization within 24-48 hrs discharge and arranging for homecare visit is best way to keep patients from being readmitted. my staff now process 1,600+ homecare referrals monthly with start of care within 48hrs norm....rate of acute care hospitalization now down to 23% from 31% 4 years ago.