Within a Medicare HMO population, enhancing conservative care by listening to and treating the whole patient by trained specialists in rheumatology and sports medicine has been shown to reduce costs significantly.25
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Explore This IssueNovember 2015
What patients say & believe are of equal importance to patient-centered care as their genetic make-up is to personalized care. Care cannot be recommended based on a population average.
Possible New Service Line Strategies & Offerings
Many discussions on listservs and at meetings are necessarily focused on fighting today’s battles while tossing out new ideas. A recent book I received from the RAND Corp., Redefining Healthcare Systems, by Robert H. Brook, MD, concludes with an essay, “Why Not Big Ideas and Big Interventions.” He asks 10 what-if questions, and I share four. What if:
- All communities had a health plan that promoted an environment in which all people could thrive and provided a totally integrated set of social and health services to aid people in need?
- Educational and health policies were replaced with people policies that targeted the interaction between health and education as the way to improve a community’s health?
- Many face-to-face physician visits were replaced by video encounters, encounters with computers and people in the community, or self-directed care—approaches that would be as effective as the traditional patient-clinician interaction but would lower costs?
- Medical expertise was shared so that by means of broadband Internet all people had immediate access, when needed, to world experts—without boarding a plane?
What if your rheumatology office offered a variety of new services with the intention of creating a new dialogue with insurers, employers and patients?
What if you designed and offered a two-month musculoskeletal consultation and care (MCC) package for patients being considered for surgery or expensive spine procedures? If it included initial consultations and up to two follow-up visits by you, a psychologist and a physical therapist, how much would you have to charge at a fixed rate to make this viable? Of course, you would need to include the face-to-face assessment, record review, care coordination and integration of other evaluations, phone and e-mail, and final report preparation time. As with research studies, an administrative overhead and program evaluation time would be built into the case fee, or for a fixed fee as a part of the annual contractual addendum. This is not an independent exam forced by the insurance company, but rather a new benefit they offer. Employers or insurers might incentivize patients to use this new care pathway by offering no co-pays.