New revamped Medicare aims to transform the treatment of life-threatening conditions, such as cardiovascular disease, while promoting quality and cost efficiency. Beneficiaries and family members may notice a new approach.
The goal is to test the notion that better coordination among primary healthcare provider and allied health professionals to prevent complications, avoid hospital re-admissions and help patients achieve post-procedural care. If it’s proven to be successful, the revamped Medicare can be adopted on a national level.
In the experiment, great results have been seen in cardiac and hip fracture treatment. It’s not certain whether Donald Trump as president will continue the support or terminate this experiment. As the Center for Medicare & Medicaid Innovation is under threat of being abolished because it was created as a provision in Obamacare.
Innovation center director Patrick Conway, who also serves as Medicare’s chief medical officer, is plowing ahead nonetheless. “Delivery system reform and paying for better care are bipartisan issues,” Conway said. And quality ranks ahead of cost savings in evaluating any results, he added.In the experiments, doctors and healthcare institution are the regular rates, if the overall quality is good and cost factor met, the hospital will receive a monetary reward. If not, the hospital pays the government money.
“Now your doctor and hospital are working together to make sure they are well coordinated,” said Conway.
Under the old system, if a patient was discharged from the hospital after a heart attack, “they might hand you a piece of paper that said please follow up with your primary care doctor,” Conway continued. “In this model, the hospital is going to have a strong incentive to make sure you follow up.”
Hospitals are unhappy with the possible “fines” that may occur, though doctors have generally been supportive. But Conway says that’s likely to entail to a higher quality of care. The intent for hospitals to monitor each other’s performance tightly and the ones that have room to improve will try to catch the high achievers.