What does the future of healthcare look like? According to an article in The New York Times, “The Face of Future Health Care,” it may look a lot like Kaiser Permanente, a company that started out as a small California hospital catering to construction workers. It branched out, became an HMO for the next 50 years, but had to reinvent itself when the HMO model lost its appeal. Now, back to about 9.1 million members, the majority of which are in California, it’s expanding again.
Why does this healthcare provider look like the future? According to the article, it has characteristics of the future model of healthcare—Obamacare. First, it’s a holistic healthcare model, combining a non-profit healthcare plan with its own doctors and hospitals. Kaiser has also spent $35 million on electronic records keeping and computer technology, which allows better coordinated patient care. These are two of the goals of Obamacare, and Kaiser is ahead of the game.
With membership, Kaiser is paid a certain amount for healthcare, so there is incentive to keep people healthy and out of the clinics and hospitals. Employers are already carrying most of the cost of healthcare. New restraints with the ACA will impose new limits on what an employee can pay for healthcare. Without cost-cutting measures and increased efficient delivery systems, Kaiser’s chief executive, George C. Halvorson, predicts the future of healthcare delivery will be either, “…rationing or re-engineering.”
Kaiser doesn’t just want to shorten the time patients spend with a doctor or in the hospital. They are looking at new technology that allows a patient to access doctors over the Internet. Kaiser feels that the way to save money on healthcare delivery is to make members more responsible for their own health, like losing weight or lowering their blood pressure. Staying healthy by making healthy choices and living a healthy lifestyle eliminates the need for expensive treatments or medical procedures.
All these changes in technology and delivery have an implementation cost. Does Kaiser’s model result in lower cost? And, will members tire of having to use Kaiser’s doctors and hospitals without the freedom to choose a doctor of their choice outside the program? After all, wasn’t that the reason they fell out of favor in the past?
Kaiser owns 37 hospitals and employs 17,000 physicians, who are paid a salary instead of being paid per procedure. Hospitals across the country are following suit, buying up physician practices, forming Accountable Care Organizations, or ACOs. All healthcare is going to travel down this path, according to Dr. Halvorson.
The danger in forming huge healthcare organizations is similar to having large, big-box retailers move in on a small town. The big guy moves in with lower prices and a lot more selection all under one roof, eventually driving out the small businesses. What is gained in lower cost is lost in a consumer’s ability to choose. But what Kaiser and other ACOs bring is integrated healthcare, where a patient can get everything they need from an office visit, diagnosis, treatment, procedures and even prescriptions under one roof. No traveling to different facilities, carrying files or medical charts from one doctor or hospital to the next. No confusing prescription medication programs that may be contradictory or even cause serious drug interactions.
Kaiser used re-engineering to overhaul its healthcare delivery system and it worked. With a holistic approach that has some of the characteristics of the new Obamacare, it may well be the model of healthcare for the future.
Photosource: Morguefile: Imelenchon