It seems that no matter where you turn these days, someone is reporting that health care in America is changing.
You may have heard terms such as “accountable care organization,” “health care reform,” and “bending the cost curve,” but what does this mean for you — the patient?
It boils down to creating a healthcare system that rewards value, not volume. The current “fee for service” system compensates doctors based on the number of patients seen or tests ordered each day. Furthermore, the sicker the patient, the higher the payment.
This doesn’t sound like “health” care. In a value-oriented system, doctors would be incentivized to provide quality care in a cost-effective manner. Doctors will be evaluated based on how well he/she treats or prevents disease. This will include measures such as diabetes, blood pressure, and cholesterol control, cancer screening, and immunizations.
Doctors in an integrated, multi-specialty group who employ an electronic medical record are at an advantage here because they have all of the patient’s healthcare data at their fingertips. This promotes working together as a team to ensure that all of the individual patient’s needs are met, while at the same time preventing duplicative testing and medication interactions.
Reducing cost does not mean rationing care. Rather, it means providing appropriate care to the appropriate patient. If there are two options for treating a disease, and both have equal outcomes, then the option that is least costly to the patient should be chosen. Often times, this means providing services at home or in the doctor’s office rather than in the hospital. It also means considering how much medications cost at the time of writing the prescription.
Overall, this is an exciting time in healthcare for both patients and physicians. There are still a lot of questions to be answered, but one thing is for sure…in the words of the great American philosopher Yogi Berra, “The future ain’t what it used to be.”
Dr. Scott T. Hines is an endocrinologist at Crystal Run Healthcare currently practicing in Middletown and Rock Hill. He is board certified in Internal Medicine, Endocrinology, Diabetes and Metabolism.