Business models at forefront of health care innovation

TalkBack 1 of 3:

Next »

• Thread View
• Flat View

You're right about the elephants

There have been too many around DC for too long and what we
have gotten does come from the end shown.

If you really want to put your mind to health care reform the
first thing to do is to put the insurance companies aside for a
while. We don't need another effort at maximizing their profits
under the guise of "reform"

For years we've been under the scope of hospital utilization
boards. My late father was actually sent home from the
hospital sicker than when he was admitted simply because the
then version of the DRG was 7 days. Out he went after 7 days
only to return with a week for a 3 week stay. The longer stay
the second time was because of a change in classification.

I don't have a problem with the DRG concept in general terms,
but believe it needs to be very elastic in it's application. That
means clearly understood variables (like age, sex and race) and
clear protection for the patient who is outside the statistical
model. To deny Doctors the right to use their individual
judgement in unusual cases is to admit that treatment is based
on dollars only, with the outcome limited to "available funds",
or the desired bonus for the insurance company's CEO - which
might be the same thing.

I also worry that a DRG has a real risk of becoming a "post Dx"
HMO type environment, where the doctors make more money
by delaying or denying treatment. We're talking about a lot of
money - enough money to ensure the patients are protected.

The extended warranty appears to be shaped in the mold of the
HMOs. Patients are, I believe, better served by paying for an
annual physical from a PCP with referrals for additional testing
or review as needed. That might be a visit to check out how a
patient is sleeping in terms of needing a sleep study, or a colonoscopy.

Posted by: Ken_z   Posted on: 02/04/09 You are currently: a Guest | Members login | Terms of Use

Alert moderator to an offensive message

Subscribe to this discussion via Email or RSS

SponsoredWhite Papers, Webcasts, and Downloads

• Building the Virtualized Enterprise with VMware Infrastructure VMware VMware virtualization software has been adopted by over 120,000 enterprise ... Download Now
• Why Isn't Server Virtualization Saving Us More? A Few Small Changes May Dramatically Increase Your Efficiency VMware Companies have rapidly adopted server virtualization over the past few ... Download Now
• Three Steps You Need to Know to Stop Data Loss Varonis Sensitive data exposed to misuse or loss... it is the stuff of nightmares ... Download Now