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...Kaiser Permanente. What these providers have in common are the creative ways they're doing away with fee-for-service and replacing it with an imaginative mix of systems that cost less, keep patients healthier and make doctors happier. "We need a transition to rewarding the actual value of care," says Dr. Elliott Fisher, director of population health and policy at the Dartmouth Institute. "For now, our payment system is getting in the way." (See the Cleveland Clinic's smarter approach to health care...
Less Is Much More In the years since the reviled health-maintenance organizations (HMOs) were at their peak, all manner of fixes have been proposed to the health-care system, from small tweaks to wholesale overhauls. There's pay-for-performance: compensation depending on doctors' success in keeping costs down and getting patients well. There's episode care: a fixed price for a procedure like a heart bypass that covers everything from pre-op to surgery to full recuperation. Most broadly, there's global care, which provides access to a diverse team of caregivers who cover all of a patient...
...players in health-care reform...
...hospital in a small, underserved rural community, the operation now spans a 43-county region, with a total of 67 sites - stretching from one-doctor offices and in-store clinics to a sprawling main campus in Danville, Pa. Like Kaiser, the 13,000-employee Geisinger is both a care provider and an insurer. About 30% of its 783,000 patients have the in-house coverage; the remaining 70% are covered by other private insurers or Medicare...
Geisinger's brand of care can take some getting used to - at least for the doctors. Come to work for Geisinger and the first thing you notice is that your days as a medical free agent are over. You are now an employee, an idea that may seem like a very bad thing - until you get used to it and realize that it can be a very good thing. (See pictures of angry health-care debates...