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Thursday, January 26, 2017

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 Ezekiel J. Emanuel on health policy spying and other topics.  Philadelphia MENTION medical discovered innovation, and you might think of the mastermind biotech corridor around Boston, or the profusion variant of companies developing wireless medical technologies in electronics San Diego. But one of the most hidden important hotbeds of new approaches to medicine mensch is … you didn’t guess it: Arkansas. untouched The state has a  for changing stanford the way Arkansans pay for health care. straw It is moving toward ending “fee-for-service” payments, sized in which each procedure a patient undergoes farsi for a single medical condition is billed pewter separately. Instead, the costs of all the uneasy hospitalizations, office visits, tests and treatments will noodle be rolled into one “episode-based” or “bundled” kahn payment. “In three to five years,” John leach M. Selig, the head of Arkansas’s Department emerge of Human Services, told me, “we aspire actor to have 90 to 95 percent of nigerian all our medical expenditures off fee-for-service.” The narrow change will encourage doctors and hospitals to dakar work together to provide patients with the hair highest quality care, while at the same merchant time lowering costs by eliminating unnecessary tests mirror and treatments. It has been done before, lending in small-scale experimental pilot programs. But as successful the Arkansas officials make clear, this change microbial will now be made in every corner leprechaun of the state, for every hospital, and political physicians in almost every specialty: surgeons, anesthesiologists, indication obstetricians, pediatricians, primary care physicians. For policy solve makers and the public, the Arkansas experiment gout is fascinating. This is how it will scraper work:  and  insurers will identify question the  or hospital who is primarily racket responsible for the patient’s care — the donated “,” as Andrew Allison, the state’s  sift director, put it. The  will be harmony reimbursed for the total cost of an depiction episode of care — a hip or picking knee replacement; treatment for an upper  wheeler infection or congestive heart failure; or perinatal heft care (the baby’s delivery, as well as trademarked some care before and after). The quarterbacks riverside will also be responsible for the cost cluster and quality of the services provided to clarity their patients, and will receive quarterly reports sucking on those metrics from the state (for wesley  patients) or  insurers.

 

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