Tuesday, September 6, 2011

Partners-Neighborhood Health

Ah, the media is all over "innovative" health care. Check out this article in the Boston Globe where it talks about a new plan where Partners Healthcare Systems Inc. (owner of Mass General, Brigham and Women's and more) will join forces with insurers to help out the low-income Medicaid patients.  How?  Here is the example given by their CEO:


A patient who has had hip surgery would have a case manager; should a problem occur after surgery, the manager would make sure the patient received prompt attention from a primary care physician, thereby precluding a pricey ambulance trip for costly emergency room care.

Ohhhhh.  So, since the hospital got its global fee for the surgery they don't want any bounce backs because they won't get paid more.  Also, they would be dinged and penalized for such bounce backs.  The way to fix this, according to this ingenious plan, would be to dump them back to their good old neighborhood family docs who have to squeeze them in as acutes and get paid jack squat for the visits.  I get it.   Boy, that is comprehensive care until you realize that there aren't enough PCPs in Massachusetts right now probably because they ARE getting paid jack squat.

Please tell me if I am reading this wrong because maybe I am just tired or stupid or cynical or.....







4 comments:

Mark Chyna said...

No, you aren't wrong... in fact you seem to be spot on.

Pat said...

Makes sense to me...I wonder what those same hospitals will do as their primary care referral base dwindles? Oh yeah...ARNP's. Problem solved.

Unknown said...

Shouldn't the surgeon be the one handling the complications?

Anonymous said...

What role is the case manager playing? Sounds like another middle man who's there to call the doc for you. Why? How much is that going to cost?