BURLINGTON, VA (WCAX) – Ohio hospital executives are offering Vermont health care leaders solutions on how to not only find more accessible and better results, but also make them more affordable.
It is part of an initiative called “Medicare Breakben.” Currently, hospitals are spending a significant amount of money serving Medicare or Medicaid patients, paying more to term insurance holders to the backend. Aging demographics predict that cost issues will worsen in Vermont.
“The underlying issue is our cost structure, which is not sustainable. If Medicare is our primary payer and it appears that some form of Medicare will grow in the new administration, then we need to lower our cost structure to be beneficial.”
How can I do it? Pronovost says it is looking for defects in patients' wellness, intake and care.
First, he says providers should encourage patients to concentrate on preventive care through annual primary care visits and cancer screening.
Next, during ingestion, the provider must check if the service site is correct. Options such as Telehealth, emergency care, and primary care offices should be weighed against the emergency department.
For those with chronic illness, ProNovost says providers need to ask themselves whether the diagnosis provided by the patient is correct, and patients are being screened for the health and social needs of the recommended treatment behavior.
Finally, is the service appropriate or necessary and all complications avoided?
By changing the location of care and finding behavioural health issues underlying physical health issues, Pronovost says that re-delegation is necessary or costly.
“The network and all Vermonters look at what the true cost of care is, how it delivers in a cost-effective way, but what does the route look like to get to that low cost of care?”
Check out our full presentation on the Green Mountain Care Board YouTube channel.
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