Highmark Says Paying Doctors More Can Lead To Lower Costs
|By David Wenner, The Patriot-News, Harrisburg, Pa.|
|McClatchy-Tribune Information Services|
As a result,
It also involves a new level of risk for doctors -- only those who attain the desired results will receive "enhanced" payments from
"What we are doing is re-empowering physicians, handing power back to them," said Dr.
Medical costs of patients involved in the pilot dropped by about two percent, while costs increased for the rest of
The medical home concept isn't entirely new. In the
"We believe there is a huge return on this," said
It does, however, result in some up front costs for medical practices, who might need to invest in things such as computer hardware and to expand or revamp their staffs.
One of the keys is a new level of electronic sharing of information between
Under this approach, the medical practice is expected to check up on whether chronically ill patients are following through on steps such as taking their medications and getting the required tests. It becomes routine for someone from the medical practice to call patients to check up on them. Kaplan noted insurers have used the approach of calling patients such as diabetics, but it works better when the call comes from the doctor's office.
For doctors, one of the appeals of the medical home approach comes from being freed up to focus on the most difficult medical situations among the day's patients, and relying on staff members to handle more routine patient needs, Kaplan said.
More than a generation ago, the health insurance concept called "managed care" gave doctors the opportunity to earn more by lowering overall costs. But it failed to produced the desired results on a national scale, with doctors complaining they were unable to make the best medical decisions, and patients complaining they were losing access to needed services.
In describing the medical home approach,
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