From the Financial Times, published January 7, 2010:
“…As part of his vision for healthcare reform in the US, Barack Obama, president, singled out Geisinger, together with Intermountain Healthcare in Utah, as model systems…
“The healthcare reform bill being finalised on Capitol Hill falls well short of Mr Obama’s initial vision for healthcare reform – and short of the standard set by Geisinger and Intermountain. But there is cause for optimism about the ‘game-changing’ components of reform that cannot be priced by economists but could bring about significant improvements in the inefficient US system….
“The Geisinger system, serving an area of Pennsylvania whose economy depends on coal mines and a nearby jail, has shaken up traditional healthcare practices with innovations considered radical in this antiquated medical system.
“For one, all records are electronic, meaning that doctors can immediately see what tests have been done, reducing double-ups and delays. The hospital’s website allows customers to book their own appointments, leading to 95 per cent attendance, compared with a 60 per cent show-up rate if receptionists book a time for the patient.
“’Telenurses’ answer calls 24 hours a day, advising patients when they should come in and when they should take some painkillers and stay at home, and they monitor people who have been discharged, reducing readmission rates.
“Most ground-breaking of all, the financial paradigm of American healthcare has been turned on its head. The 650-plus doctors at Geisinger are salaried, with 20 per cent of their packages in bonuses awarded for quality, rather than the number of patients they treat. This is a stark change from the practices at most hospitals, where doctors are paid a fee for each treatment, making it worth their while to do more tests and procedures.
“’If my patients have fewer complications, I get paid more,’ says Kimberly Skelding, the cardiac surgeon …
“In other American hospital systems, women have to pay for every consultation every step of the way. At Geisinger, they package treatment into an 11-month bundle covering pre-natal care, birth and the six weeks after delivery.
“By fixing the costs in advance this way, the Geisinger system transfers the risk on to the hospital and the doctors to be as error-free as possible because the hospital assumes the risk.”
To read the rest of the article, click here.
