How is it possible that the medical field missed the IT revolution? So everything from patient history to baseline tests gets repeated over and over again. Even though the Affordable Care Act (a.k.a. Obamacare) includes incentives to adopt electronic record keeping, there's still no common platform or file standards for sharing. We need a cloud to eliminate this useless duplication of services.
As many as 15,000 Medicare patients a month die from an "adverse event" while in the hospital, according to the Agency for Healthcare Research and Quality. That costs the healthcare system some $2 billion a year says the Institute of Medicine. The lion's share of medical errors involve medication mistakes, many of which could be prevented with better packaging (bar codes, color coding, distinctive naming, per-dose-packs). Better staffing policies, limited shifts and hospital safety policies might cost a little more up-front, but it's nothing compared to what we'll save by reducing errors.
11 Ways to Save Healthcare
#2. Reduce Errors
#1. Share Electronic Medical Records
Here's an idea. Before we throw out the well-baby care with the bathwater, maybe we could get together to implement some common-sense healthcare fixes. Here are 11 ideas to get us started.
Ulysses S. Grant
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An Opinion Piece by Patty O
#3. Let Doctors Be Doctors
The last thing we need is another layer of bureaucracy between us and our doctors. Medical offices spend more time adhering to government and insurance regulations than they do treating patients. Why not leave the big decisions where they belong: between a patient and a physician? Why don't we consolidate billing pratices so there's one form for every claim? What if we stopped forcing physicians to defend their treatments and made regulators prove why a decision should be challenged? Every layer of bureaucracy we remove today will save us dollars tomorrow.
Combine ideas from both sides of the political aisle.
Have a positive slant.
#4. Provide Real Patient Advocates
It's been called one of the best jobs of the future. But instead of limiting these professionals to complaints and problems that have already occurred, let's empower them to save patients and money. Get them involved in patient care from the beginning. Have them look for contradictions and help catch errors before they happen. Charge them with tracking treatments and comparing that to invoices to reduce fraud. Let them explain options to the family the second and third and fourth times. More proactive patient advocates would pay for themselves many times over while they inject care back into the healthcare system.
#5. Pass Tort Reform
In recent years, malpractice insurance costs and claims have skyrocketed, driving good doctors out of business and driving up the cost of care. The kinds of reform outlined in the proposed HEALTH Act - including caps on awards and a statute of limitations - could save up to $54 billion over 10 years estimates the non-partisan Congressional Budget Office. That savings is achieved by a 10% reduction in the cost of malpractice insurance and the elimination of all the unnecessary, defensive testing done today.
#6. Eliminate Fraud
In February 2011, the U.S. government executed the biggest fraud crackdown in Medicare history, netting 111 arrests accounting for $225 million in false billings. The FBI currently has another 2,600 cases under investigation. And guess what? It's thanks to the Affordable Care Act which increased the resources to find fraud, the penalties for committing it, and the government's ability to recover the losses. But the first line of defense has to be we the people. We have to pay attention, make sure we don't get billed for things we don't receive, and report any false charges to Medicare. You could even get a percentage of the funds the government recovers as a reward. So if we let the law work - and work the law - we could eliminate an estimated $60 billion in fraud every year and properly punish the people who are stealing from us all.
#7. Increase Delivery System Efficiencies
Not every medical need requires a physician. Blood work can be done in a lab. Preliminary care can be performed by Registered Nurses and Physician Assistants. Triage models in emergency rooms can direct patients to clinics that can handle non-life-threatening care. Hospitals can specialize - cardiac here, orthopedics there. Communities can develop and coordinate regional care models that maximize the use of all equipment while making services accessible to all patients.
#8. Train Physicians in Exchange for Service
While seniors are struggling to find doctors who will accept Medicare, doctors who can afford the $100,000 or $200,000 or $300,000 it takes to go to medical school in America are going into specialties where they can make the most income. Why not make a trade? We'll pay for the medical education of talented students in exchange for service to the Medicare community for a pre-determined amount of time at a fixed salary. It's a proven model. Similar programs through The Armed Services, the Cleveland Clinic, the Mayo Clinic, and the National Health Service Program receive many more applicants than they can accept. Let's redirect that unfunded talent where it's needed and take steps toward a fixed cost of care in the process.
#9. Change the Fee for Service Model
Currently, the more your doctor sees you, the more tests a physician reviews, they more he or she gets paid. It's a built-in incentive to over-prescribe, order extra procedures, or schedule office visits when a phone call or email will do. The system isn't fair to physicians either. Congress can change what Medicare pays whenever it wants, leaving them scrambling for ways to regroup. It's time to explore other payment options such as the pay for performance model (doctors get a salary plus bonuses)that's been successful in Massachusetts.
#10. Negotiate for Drugs Nationally
When Medicare Part D was passed in 2003, it gave seniors prescription drug coverage. But it also tied government hands, prohibiting the kind of national negotiation with pharmaceutical companies that other countries use. So the same medication in Canada or Mexico or Europe is still less - sometimes much less - than what we pay. This one ought to be a no-brainer.
#11. Let People Opt Out
In the words of former House Majority Leader, Dick Armey, "Why can't the United States government allow Dick Armey … (to) opt out of Medicare without being punished?" Indeed. Why not? As long as he pays his Medicare taxes, who cares if Armey and other self-proclaimed "old geezers" don't take their benefits? Granted, it's not much of a savings. But for those of us who are counting on Medicare, every little bit counts.
Poll after poll shows that the majority of the American people want healthcare. So let's meet in the middle and make changes that make sense. After all, we're the nation that pays twice as much as any other country for quality that's ranked 37th by the World Health Organization. There's obviously room for improvement ... if only Congress were willing.
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