A Model for Future Healthcare

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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


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  • mary w
    mary w
    people do not want to have to change from the doctors they have had for years and have to get refferals to be seen by a specialist they want the freedom to go where they feel comfortable and where the can honestly feel that they are recieving care from a compitent md and one who know them and they can trust that they have thier health in yhe best intrest and not just trying to save the insurance money
  • Susan k
    Susan k
    I agree the holistic wellnes is appropriate because of so many complications due to an abundance of medications prescribed that patients become dependent on, instead of healing the body and the brain.
  • Carol H
    Carol H
    Excellent article. It agrees with my philosophy of healthcare : "Always provide  access with accuracy and automation." It gets is right the first time which simplifies care in a very complex healthcare environment.  C
  •  Denise H
    Denise H
    It sounds feasible. What role will social workers have in this re engineering?
  • elizabeth  anne b
    elizabeth  anne b
    I totatly agree this is the new tecnolagey will work in any country world wide.This is beter health care for old and young.No more standing in lines, screaming ill kids or having to take a picnic basket when you go for an apoinment.
  • Katherine C
    Katherine C
    I'm glad you listed the criteria for the words "integrated" and "holistic" because it appears they still fall within the realm of allopathic medicine.  I would like to see those definitions expand to include whatever will make the patient well, whether it be chiropractic care, dietary adjustments, therapeutic massage, acupuncture, meditation or other modalities of care.  Kaiser and other "integrated" and "holistic" clinics have done much to re-engineer our healthcare delivery system.  I and many other consumers are looking forward to the next step which includes not just the modalities listed above but also the education of our healthcare insurance providers and a complete overhaul of their system.  Thank you
  • LaDonna W
    LaDonna W
    Like the idea. I was sure it could be done. I think doctors should work for the hospital as employee just as all other staff members
  • Vlasta Kathie B
    Vlasta Kathie B
    Sounds good. I know also that Kaiser has high patient safety rating!
  • Kathleen R
    Kathleen R
    Does this care include alternative health care like chiropractic, naturopathic, and acupuncture? And is this service available in all areas?
  • Holly C
    Holly C
    I believe it may continue to work for the already existing members of Kaiser - most likely not even by choice, because not many employers give you a choice - But I don't think it will be the number one choice for the majority of individuals. Those who will be forced to purchase insurance on their own, simply because they are unemployed. These people will never have the resources it will take to pay a monthly premium for something they feel is not on top of their priority list. In other words - pay a premium or feed my family this month. In addition, the ones that will be able to afford it may only choose Kaiser if they are fit and healthy to begin with. They are the ones that don't really mind being forced to see specific providers within a network. It's the people that are NOT healthy, that have numerous issues and need Specialists that will be leery. I have mixed feelings about Obamacare....As far as this being the 'Model' of healthcare for the future - we shall see...there are already other Healthcare companies with a similar approach in place ~ eg: CareMore....in Los Angeles & Orange County, CA as well as NV, AZ, VA, NY - but  the name is not as familiar yet. They were recently aquired by WELLPOINT, which is better well known on the East coast. We shall see what the future holds for them. Other companies, such as United Healtcare offer huge provider networks across the country, especially for their Medicare Advantage plans for the Senior citizens who are enrolled in Medicare. They have many more options. If the private individual has the same options, then they might continue to give Kaiser a run for their money. Again...we shall see.
  • Virginia A
    Virginia A
    This is not a plan to improve the medical delivery system. It is a plan to control physician decisions and lower the standard of medical care. In most cases we can already receive during an office visit a diagnosis,treatment and any needed prescription. You can also have prescriptions filled on site . There will also always be the need for referral to a specialist , 2nd opinions etc . Hospitals will buy up practices to control the level and quality of care and I do not make this comment in a positive manner. The transfer of medical records is already able and is done electronically in most cases . This is not innovative, it is simply the continued path we are on to a lower level of medical care and access .
  • Lucinda E
    Lucinda E
    This is surely, then, what we mean by leadership by example.  

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