Last Update: Wednesday, July 23, 2014

LIFELONG HEALTH Outcome-Based Payments Have Cost-Saving Potential PDF Print E-mail
Written by David Lipschitz   
Thursday, 24 May 2012 06:59

A New York Times article also published in the Arkansas Democrat-Gazette discussed a slowdown in the growth of health spending. Before 2009, health care spending invariably rose at 3 or 4 times the rate of inflation. But in 2009 and 2010, costs increased by only 4 percent and remained flat at 18 percent of our gross domestic product.

Experts suggest that the major reasons for the decline are the recent recession, job losses and fewer Americans with health insurance. With fewer Americans having access to health care, doctor visits declined, fewer tests were done and the number of people seeking care for minor problems in emergency rooms decreased.

Because many Americans are worried about job security, fewer are willing to take time off for elective surgical procedures. Insurance plans with lower premiums — but higher deductibles and co-pays — have led consumers to think twice before seeing a physician or agreeing to expensive care. In the past few years, the number of workers with high-deductible insurance has increased from 3 percent in 2006 to 13 percent in 2011.

But it is encouraging to note that the slowdown in the rate of health care inflation cannot be explained solely by more uninsured Americans having less access to care. There is compelling evidence that health care providers are being much more prudent in ordering tests, performing procedures and/or prescribing the most expensive medications. And simultaneously, health care consumers appear to be taking a more active role in their health care and are beginning to discuss costs, rationale and the necessity of treatment plans recommended by their physicians.

As the Affordable Care Act becomes a reality, Medicare and Medicaid, as well as private insurance plans, are shifting payment to what is referred to as "accountable care" where physicians are paid for quality rather than the quantity of care delivered.

This approach will alter the way medicine is practiced and is designed to not only save money but to also improve the quality of care by focusing on prevention, better coordination of care, avoiding unnecessary care and doing everything possible to keep patients as healthy as possible and away from emergency rooms and hospitals.

Throughout the nation, partnerships among government and private insurers, primarycare physicians, specialists and hospitals are being forged into "accountable-care organizations." In the past, our health care system rewarded hightechnology acute care at the expense of managing and preventing chronic diseases.

In a true paradigm shift, more attention now will be paid to coordinating the care of patients with multiple chronic diseases, assuring compliance with medication, careful and appropriate monitoring of the response to treatment, and preventing complications and aggravation of illnesses.

The goal is maintaining health and avoiding the need for hospitalizations. This care will involve close partnerships among physicians, physician assistants, nurses, pharmacists, social workers, dietitians, and rehabilitation experts. These teams will have incentives to practice the right care and reduce costs while being monitored to assure that the quality of care benefits the overall health of their patients. Quality will be measured by how appropriately patients are managed, the frequency of complications, the number of visits to the emergency room, and admissions to the hospital.

In the future, our goal must be for every American to have access to inexpensive and rational health care. Whatever the Supreme Court decides about the constitutionality of the Affordable Care Act, the writing is on the wall for everyone involved in health care. The end is in sight for those who believe that the fancier the test, the more expensive the drug and the newer the technology, the better the health care facility.

Those institutions that continue to tout the newest and best equipment and the best possible resources for every acute-care problem are looking backward and not paying to attention to our critical future needs.

Share
Last Updated on Thursday, 24 May 2012 07:11
 






Team members care for thousands of the region's sickest children with heart conditions, including fetuses, newborns, infants, children, adolescents, and adult, long-term patients with pediatric cardiovascular conditions. At Children's families experience coordinated, next-generation care, delivered by a compassionate, multidisciplinary team of leaders in the pediatric cardiology field. One of the largest pediatric cardiovascular programs in the region. Studies have shown that high volumes are associated with high quality and better outcomes, because experience is a major factor in quality of care. Wort was traditionally prescribed in parts of Europe for depression (in addition to use as a general-purpose tea), and Chinese medicine developed elaborate lists of herbs and preparations. With the scientific revolution in Europe and the United States, the use of traditional herbal remedies fell out of favor with the mainstream medical establishment, although a few people continued to use and maintain knowledge of traditional European herblore. In the early 20th century, scientists began reassessing this rejection of traditional herbs in medicine. Vorzüge eines intakten und lebendigen Gemeinschaftslebens bewahren. Dafür sorgen nicht zuletzt gut 120 lokale Vereine. Als wichtiger Faktor im Kulturleben haben sich die zahlreichen Museen und einige Kunstgalerien erwiesen. Descriptive and quantitative transcriptome analyses are important for interpreting the functional elements of the genome and revealing the molecular constituents of cells and tissues. It is known that sperm function can be affected by ASG proteins, including the processes of capacitation and the acrosome reaction, as well as canadian pharmacy accutane sperm motility, DNA integrity and interaction with the oocyte. BSPs (bovine seminal plasma protein, unigene 64,588 and unigene 69,768), fertilin (unigene 17,270 and unigene 27,136), ACE (Angiotensin converting enzyme, unigene 7,164 and unigene 21,069), GPX5 (glutathione peroxidase, epididymal secretory glutathione peroxidase, unigene15860), Spermadhesin-1 (Acidic seminal fluid protein, aSFP). The reproduction-related transcripts identified in the ASG and testis transcritptomes in E. This interaction of PDC-109 with the sperm cell membrane results in an efflux of cholesterol and choline phospholipids, that appears to be important for capacitation. The main changes in spermatozoa that occur during epididymal maturation are the ability to move, recognize and bind to the ZP, and to fuse with the plasma membrane of the oocyte.. Oct 2004, Adelaide, Australia. Ziaian T, Augostinos, M. Relationship Between Acculturation and Mental Well-being Among Young Persian Women Living in Australia. Paper presented at the Educational Research conference, 18th November 2004, Adelaide, Australia. Ziaian T, Stress Management: an introduction of holistic coping strategies. A Four day Course for the higher degree students. Targeted molecular therapy for advanced epithelial ovarian cancer. Minimally invasive surgery for gynecological cancer. Pharmaceutical Sciences from Shizuoka College of Pharmacy (1976, Japan). He has completed his B. Prophylactic removal of nevi without clinically worrisome characteristics is not recommended. The reasons for this are practical: many individuals in these families have a large number of nevi, and complete removal of them all is not feasible, since new atypical nevi continue to develop. In addition, individuals with increased susceptibility to melanoma may have cancer arise de novo, without a precursor lesion such as a nevus. The disadvantages of screening include the limitations of available noninvasive testing methods and the risks associated with invasive screening procedures. ERCP is the gold standard for http://www.jerseycanada.com/jerseyatlantic/fnt/ultramer.php identifying early cancers and precancerous lesions in the pancreas..