November 25, 2011

STRIPPING THE CASH FROM THE COWS:

College Tries Alternative Care Scheme (Chris Fleisher, 11/24/11, Valley News)

Dartmouth Health Connect puts into practice many of the ideas, particularly the call for taking a team approach to delivering health care, that have been championed by researchers at The Dartmouth Institute and the newly established Dartmouth Center for Health Care Delivery Science, said Dr. Albert Mulley, the Center's director.

The new practice, which will be open to Dartmouth employees, scraps the old physician-centered model in favor of a health care "team." The team includes two Dartmouth-Hitchcock physicians, a nurse, practice coordinator and "health coaches," who will be in touch regularly with patients to make sure they're staying on top of medications and doing the things they need to stay healthy. Iora will manage the practice and, with the exception of the two D-H doctors, hire the employees.

The team will talk with one another, email and phone patients, involve family members and even other outside physicians who are responsible for caring for a patient.

"What's sorely missing in health care is shared teamwork," Mulley said in a telephone interview from London, where he is a fellow at The King's Fund, a charity designed to improve health care in England. "It's all about coordination. It's all about being on the same page."

Another major change will be in how the care is paid for. Health reform advocates have criticized the existing fee-for-service model as being one that promotes treatment of sickness rather than maintaining good health.

With Dartmouth Health Connect, there will be no bills to insurance companies for treatment. Instead, Dartmouth bypasses the third-party insurers and will pay Iora a flat fee for each patient. The hope is that this will give caregivers an incentive to keep patients well rather than seeking more procedures, since it will cost the same either way. It means fewer administrative hassles to deal with billing, and patients won't be charged a co-pay fee for each visit.
Posted by Orrin Judd at November 25, 2011 8:47 PM
  
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