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Collaborative Care Pays Off

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  • In Coding
  • January 13, 2012
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A unique program in Oregon between an employer and caregivers is reaping benefits.
Peter Cady, severe back pain spasm sufferer who spent 12 hours a day on his feet, was fed up with seeking medical help. By the time he could be seen by a referred specialist, the spasms would usually be gone. Fortunately, collaborative efforts were made and his new care proved to save money and time, and improve his health.
Rather than waiting to see a doctor, Cady and other routine back pain patients working at Intel in Hillsboro, Ore., now see a physical therapist within 48 hours of their appointment call. Previously, it was approximately 19 days. Now, his treatment is complete in 21 days, rather than 52 days. Due to fewer unnecessary doctor visits and diagnostic imaging tests, per patient cost has dropped and patients return to work faster.
The new collaboration effort “is a real bureaucracy buster that gets you right straight to someone who can take care of the problem,” said Cady, 47. “Before, the doctor wasn’t helping me or explaining anything. But the physical therapist educated me, gave me stretches and exercises to do, and cleared it up.”
“The change came about through an unusual collaboration between Intel, two local health care systems, and a health insurer. Based on that success, the partners have developed similar improvements for hip, knee, shoulder and headache treatment. Intel and its partners say the result has been $2 million in administrative savings this year, from reduced costs for patient scheduling and registration, for example,” reported Kaiser Health News.
The collaboration in Hillsboro is part of a growing number of partnerships aiming to tackle unsatisfactory quality and rising health-care costs throughout the country. Other programs are located in Atlantic City, N.J., Lewiston, Maine, Muskegon, Mich., Sacramento and San Francisco, Calif., and Seattle, Wash.
Dr. Robert Mecklenburg—a pioneer who developed a collaborative effort at Virginia Mason Medical Center in Seattle, and who worked with Starbucks and other employers in 2004 to form collaborations—said, “I practiced for 30 years without knowing how long patients waited to see me.” After he met with the employers, he realized “how important it is to see patients when they need to be seen. Any wait is not OK.”
Although the collaboration may seem like a win for all parties, there are still obstacles. According to Kaiser Health News, “It’s often difficult to get traditional competitors and antagonists to collaborate, including sharing proprietary medical and financial data. Some employers are reluctant to get directly involved in how health care is delivered. Critics warn about rationing of care. And some physicians complain about interference with their professional autonomy, although Mecklenburg says most come around when they see better results for patients.”
Insurers in Sacramento have embraced collaboration. Blue Shield of California, Catholic Healthcare West, and Hill Physicians Medical Group have worked with CalPERS, the state public employee benefit system, to redesign care after they identified quality problems and high costs for 42,000 plan members. The collaboration worked, according to Kaiser Health News: “Hospital length of stay and readmissions both declined 15 percent in 2010,” which helped “save more than $20 million, exceeding the $15.5 million target.” This allowed “Blue Shield to keep CalPERS’ premiums flat in Sacramento for 2011. The remaining savings were split among the three partners, who would have lost money if the target hadn’t been hit.”
Since Blue Shield has seen the benefits of collaboration, it is “working with its current partners and several additional provider organizations to improve care for 26,000 members of the San Francisco public employee plan,” reported Kaiser Health News. “It’s also starting partnerships in January for 38,000 plan members in California’s Orange and Stanislaus counties.”
Source: Kaiser Health News

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