Lowering Medical Costs - A Model for Reform

Today I was driving between meetings and caught a part of NPR's Fresh Air, where they were interviewing Atul Gawande, a staff member of Brigham and Women’s Hospital, an associate professor of surgery at Harvard Medical School and an associate professor in the Department of Health Policy and Management at the Harvard School of Public Health. He was a senior health policy adviser for President Clinton. He is a staff writer for The New Yorker magazine and also the author of several books, including The Checklist Manifesto and Better. Today was a particularly interesting day because of the House repeal of of Affordable Care Act, and so this Fresh Air interview was quite timely.

In the interview, Gawande outlined several examples where innovative initiatives to focus on health outcomes, rather than fee-for-service payment structures, saved communities huge amounts of money. For example, he profiles Jeff Brenner, a family practitioner working in Camden, N.J. In 2007, Brenner started treating chronically sick people who accounted for a significant percentage of the health care costs in Camden. By helping them, he could also lower the health care costs — not just for them but for the entire city of Camden. He decided to start, just one-by-one, taking care of the people who were in that top percentage of costs.

According to Gawande, after three years, Brenner and his team appear to be having a major impact. His patients "averaged 62 hospital and E.R. visits per month before joining the program and 37 visits afterwards — a 40 percent reduction. Their hospital bills averaged $1.2 million per month before and just over half a million after — a 56 percent reduction."

The method that Brenner used was not all too revolutionary - a simple mixture of social work, case management and primary care.


See : www.goloox.com