[to top of second column]
Some health systems limit overuse by putting doctors on salary instead of the usual fee-for-service. Fisher says physician teams help, too. Instead of waiting a week for a specialist to run a heart test, the family doctor asks a collaborating cardiologist which test to order and consults with the result.
Then there's Geisinger's approach, called ProvenCare. Surgeons at the Danville, Pa., hospital turned national guidelines for heart bypass into a specific checklist of 40 best practices -- like ensuring that antibiotics, blood thinners and other medications are given correctly before and after surgery, and that proper pre-surgery tests are in. Miss a step and the operation's canceled.
At the program's start, 60 percent of patients got every check. Today, all do.
Then came the price test: Patients insured through Geisinger's insurance unit are charged a set price for the surgery and all pre- and postoperative care, that 90-day warranty.
"We were pretty nervous that this could be upsetting an apple cart," says associate chief medical officer Dr. Alfred Casale.
But ProvenCare patients are recovering faster, rehospitalizations for complications have fallen 40 percent -- and the hospital and its health plan have saved thousands of dollars, he says. So Geisinger expanded ProvenCare to half a dozen other areas, from joint replacement to obesity surgery, and is negotiating with other insurers to join.
The lesson: "There were things that would get dropped, and we didn't know that until we started auditing it," says nurse Linda McGrail, joint replacement coordinator.
Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
< Recent articles
Back to top
News | Sports | Business | Rural Review | Teaching & Learning | Home and Family | Tourism | Obituaries
Law & Courts |
Spiritual Life |
Health & Fitness |
Calendar | Letters to the Editor