Comments on: Employers as Doctors

By: asthma clinics

asthma clinics — Wed, 30 Jan 2008 02:15:10 +0000

asthma clinics

Very interesting post. A little bit confusing, but still ok.

By: Jack

Jack — Tue, 29 Jan 2008 05:00:13 +0000

Jack

great blog post

By: Uwe Reinhardt

Uwe Reinhardt — Fri, 16 Mar 2007 15:34:13 +0000

John:

When you say that “Granted, this mainly is the result of the way the
government pays for care, but all the private payers pay the same way the government does” you show that you must have been still a baby when Medicare was passed.

In 1965, Medicare had to adapt its payment practices to the way private health insurers paid doctors: usual, customary and “reasonable” (UCR) fee for service. It was an explicit part of the deal.

No one would have stopped private health insurers from inventing more innovative ways of paying doctors, then or now. They left the innovations (DRGs, RBRVS) to Medicare. If they had found a better way, Medicare would have copied it.

Uwe

By: Bob Kramer

Bob Kramer — Thu, 08 Mar 2007 14:29:54 +0000

John;

I could not agree more. These initiatives are destroying the practice of
medicine for reasons I cannot fathom. Do they think they will save money
and bring down the cost of healthcare? Not likely. This will now add to
the disconnect between the time honored doctor/patient relationship,
further cut into the earnings of primary care providers, and further
denigrate to role of the “family” physician.

By: Sue McFellan

Sue McFellan — Fri, 02 Mar 2007 15:43:53 +0000

There is payment for “one of the most important services”: skilled home health care. It is uniquely suited to teching patients how to manage their own health care and has been quietly doing so for about 100 years.

When will the vaunted acute care system recognize the critical contribution of post acute care and start to take responsibility for the outcome patients care about: the restoration of the ability to perform basic tasks of daily living for themselves?

By: Chuck Reynolds

Chuck Reynolds — Thu, 01 Mar 2007 22:48:58 +0000

A useful way to look at what companies are doing with on-site clinics is to view it as an immediate solution to a health care supply chain issue. For the exact reason that reimbursement systems are muddled with perverse incentives that drive wasteful and ineffective care behaviors, employers are shortening the supply chain for primary care services. They are skipping insurance intermediaries to pay docs, nurses, pharmacists and health educators to deliver the right services to the right patients at the right time. And, their employees receive services within walking distance and be back on the job within minutes, not hours.

Rather than be critical of such a strategy, it is better to hold it up as a model for how health care should work, and to consider how it can be replicated more broadly in the marketplace.