Gosser Group Healthcare Business Blog

Healthcare Value (part three) - Five Ways to Fix Primary Care

Fixing Primary Care

 

In my previous posts, I described the challenge of healthcare value and identified primary care as a solution, but not until Primary Care is working well.  How do we fix the primary care problem in this country?  Here are a few recommendations:

 

1.      Higher pay from health plans for primary care.  The cost-containment push has been too stringent on primary care physicians as this specialty has been caught in the crunch of downward pressure on all health care providers.

2.      Management tools for health and wellness, prevention, and disease management need to be made available through primary care physicians—not the insurance carrier nor the employer, nor the hospital or pharmacy company. 

Healthcare Value (part two) - Primary Care is the Solution

Primary physician services are a fundamental part of reversing the trend and demand curve in health care.  In many ways, it is about getting back to the basics.  As consumers, we have access to highly sophisticated technology and specialty care.  However, we lack the depth of knowledge and judgment about necessary and appropriate steps in health and treatment.  We need greater access to primary care coaches or confidants.  These primary care professionals can relieve us of anxiety over routine or minor problems and direct us in the most effective—and most efficient—treatment paths for something major.  Barbara Starfield, M.D., M.P.H. of Johns Hopkins University cites numerous studies showing that primary care is associated with lower health costs while achieving lower mortality and morbidity rates.

The Challenge of Health Care Value (part one)

By Bruce Gosser

Health care organizations, whether physician or hospital providers or health plan payers, are hard-pressed to address the issue of value in health care purchasing.  The United States spends more on health care than any other nation.  Much of that spend is “because we can” in the affluent culture we enjoy.  The U.S. also generates most of the technology and pharmaceutical innovations in health care, as well.  Still, the question of value must be taken seriously.  “The underlying root cause of the problem with our health care system is excessive costs. Although many factors contribute to excess costs, the most important factor is overuse of expensive modalities.”  (Karpf, Michael MD; Lofgren, Richard MD; Perman, Jay MD, Academic Medicine, November, 2009)

Healthcare Data Integration - Will EHR Adoption Widen the Gap?

By: Rob Hubert, Executive IT Consultant at Gosser Group

While I have no doubt that the ARRA stimulus dollars will speed adoption of EHR's, I wonder if the loosely defined plans for integrating these newly born silos of patient data will ever come to fruition. The lack of standards and the limited success of integration vendors is highlighted in a new report from KLAS, titled "Health Information Exchanges: The Reality of HIE Adoption", where they validated 89 live HIE organizations that use commercial technologies to share patient data. According to the Press Release this week: 

"Though marketing by some vendors would suggest that many examples of successful health information exchanges (HIEs) have been built on their solutions, the reality of HIE adoption is quite different. According to a new report from KLAS, only a relatively small number of vendors have risen to the challenge enough times to claim a proven, repeatable model."

The Advantages are Clear in Cloud-based EHRs

By: Rob Hubert, Executive IT Consultant at Gosser Group

Now that Meaningful use has been defined, physicians are ready to commit to an EHR solution for their practice. At last count there were over 400 choices available in a software market that has yet to experience significant consolidation. Most traditional EHR's have been developed in locally installed two-tier client server architectures, where the physician is required to buy the software and the hardware for their office. These systems were designed in the late 1990's, which gives them an advantage in capabilities, but a huge disadvantage in flexibility, supportability and integration with other systems.

What’s Right About Healthcare Reform? Bundled Payments

By: Bruce Gosser

The health care reform debate has centered on the public policy issues of government-sponsored health plan and abortion coverage.   Buried deep within the body of the bills passed by both the House and Senate is a measure that reforms the current fee-for-service payment system for post acute care known as bundled payments.  Bundled payments is a more subtle and complex provision of the proposals with potential to realign provider incentives and encourage new focus on health rather than sickness.  The measure has been included in every proposed reform bill, including efforts from the Bush Administration in 2008 to introduce Bundled Payments for Medicare.