New system in Ark. emphasizes health care quality
By CHUCK BARTELS, Associated Press | |
Associated Press |
The plan was developed with input from physicians, insurers, state officials and others as a way to get a handle on costs while not reducing the fees that providers receive. The first changes begin in July _ though the full program will take years to roll out.
The program isn't tied to the federal health care law that was upheld Thursday by the
Selig said there are tremendous inefficiencies in the system that need to be removed to bring down costs.
"Health care in this country doesn't work particularly well," Selig said.
The group found that a large number of patients hospitalized with congestive heart failure wind up back in the hospital in a relatively short amount of time. The new system will focus on getting that patient proper follow-up care and, through electronic health records, help the specialist better communicate with the patient's general practitioner. Supporters said that should reduce the number of patients heading back to the hospital.
State Medicaid Director
The state has been working with federal
As the number of patients with insurance or in the
Selig noted that a number of states have handed management of their
"We wanted to focus on getting rid of inefficiencies (and) spend our health care dollars well," he said.
"We're trying to pay better, not pay less," Spaulding said.
Dr.
"We're not requiring everybody get the same care every time," he said.
Goldman said that 60 percent of patients treated for a sore throat leave the doctor's office with an antibiotic prescription, yet only a small percentage actually have a bacterial infection. Identifying the patients who actually need the drug will cut costs, ensure patients receive proper treatment and reduce unnecessary use of antibiotics, he said.
Launching in July will be five treatment areas in which the state and the insurers will try to contain costs: hip and knee replacements, pre- and post-natal care, upper respiratory infections (colds and sore throats), congestive heart failure and attention deficit and hyperactivity disorder.
The idea is to eliminate inefficient care and overtreatment, and promote proper treatment. More categories will be added as time passes and the system is refined.
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[HCM]-CM program keeps high utilizers out of hospital
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