Hello Fairfax: It’s Time to CareMore!!
Thursday, 20 October 2011 10:40
Hello fellow baby boomers! Are you caring for an elderly parent? About one-third of us are …everyday. Frustrated by the current health-care model???
I share your frustration! My Dad is 86 and has been diagnosed with congestive heart failure and chronic kidney disease. He lives alone in his home. Since Father’s Day, he has been hospitalized 6 times as we struggle to control his lasix and warfarin levels. Too little and he can’t breathe (two hospitalizations); too much and he is dehydrated and confused (another hospitalization). Dad has good medical coverage, we have hired help in the home, and a home health nurse visits every 3-4 days to help us monitor his meds. It’s labor-intensive, requires lots of coordination by us as Dad’s team of caregivers and advocates, and is a day-to-day balancing act with LOTS at stake…our Dad. Is there a better way?
The November issue of The Atlantic has a must-read article “The Quiet Health –Care Revolution” by Tom Main and Adrian Slywotzky. http://www.theatlantic.com/magazine/archive/2011/11/the-quiet-health-care-revolution/8667/ . It’s the story of a small healthcare company called CareMore, started by Dr. Sheldon Zinberg in Southern California in the 1990s centered on treating the elderly, and in particular the frail, high-risk elderly who drive up costs. The premise: treat the whole patient, spend money for transportation needs so that elderly patients CAN make and keep their appointments, and use technology (e.g. a wireless scale read daily by clinic staff to monitor weight gain for someone with congestive heart failure).
CareMore’s coordinated approach is paid for by Medicare Advantage program; CareMore gets an annual per-patient fee adjusted to the patient’s risk profile. This system, unlike the fee-for-service model, rewards innovative, results-oriented care. It uses an old systems-management model developed by Bell Labs in the 1930s: you can fix a problem at step one for $1, or fix it at step 10 for $30.Intervene early e.g. get the diabetic patient with the cut on his foot seen and followed regularly and you avoid a much more costly outcome: gangrene and a foot amputation. What do the CareMore patients think? 97% are either satisfied or very satisfied with the health plan; 80% would recommend it to a friend.
And the all-important bottom line….you CAN prosper while practicing good medicine! CareMore was purchased by private investors in 2006. Under CEO Alan Hoops, profits grew from $2 billion in 1993 to $11 billion in 2000. This past August Wellpoint, which serves 69 million people through its’ Blue Cross and Blue Shield health plans and subsidiaries across the country, acquired the company. Wellpoint sees tremendous potential-- with 1 million Baby Boomers in WellPoint’s service area joining Medicare between now and 2030.
So, this is a model to watch. If and when it becomes available in Fairfax, we need to support it. Ask any caregiver or an elderly neighbor. The health care system needs a HUGE dose of common sense. We need a system that improves health-care quality while reducing costs….and is centered on providing the BEST care for each individual patient. Can we “CareMore” in Fairfax? Yes, we can!
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Friday, 30 December 2011