If asked the purpose of the Affordable Care Act, most people would say it is to bring insurance to millions of the previously uninsured. And that is a major goal.
But just as important and integral to being able to provide insurance is to provide better and more economical health care. How this is being achieved is dramatized in a full page advertisement today placed in the New York Times by Manhattan’s Mount Sinai Hospital.
In one inch high letters, the ad virtually shouts: “If our beds are filled, it means we have failed.”
In text above it goes on to ask:
“Can Mount Sinai be serious? The answer is a resounding yes. In fact, we couldn’t be more serious.
“Mount Sinai’s number one mission is to keep people out of the hospital. We’re focused on population health management as opposed to the traditional fee-for-service medicine. So instead of receiving care that’s isolated and intermittent, patients receive care that’s continuous and coordinated, much of it outside of the traditional hospital setting.
“Thus the tremendous emphasis on wellness programs designed to help people stop smoking, lose weight and battle obesity. By being as proactive as possible, patients can better maintain their health and avoid disease.
“Our Mobile Acute Care Team will treat patients at home who would otherwise require a hospital admission for certain conditions. The core team involves physicians, nurse practitioners, registered nurses, social workers, community paramedics, care coaches, physical therapists, occupational therapists, speech therapists, and home health aides.
“Meanwhile, Mount Sinai’s Preventable Admissions Care Team provides traditional care services to patiens at a high risk for readmissions Through a comprehensive bedside assessment, social workers partner with patients and caregivers to identify known risks such as allergies to medication. They’ll even deal with concerns like housing and literacy.
“It’s a sweeping change in the way that health care is delivered. And which the new system comes a new way to measure success. The number of empty beds.”
What is playing out here are the financial incentives provided by the Affordable Care Act to both improve health care and provide it more efficiently.
Keiser-Permanente pioneered this approach on the West Coast many decades ago and more recently Geisinger has led here on the East Coast.
The Affordable Care Act encourages fees for outcomes rather than fee for services. Among other things, incentives reward overall positive results over large pools of patients.
We anticipate that Lancaster General / University of Pennsylvania network soon will follow.
