Word: systemize
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Dates: during 2000-2009
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Family physicians in the Geisinger system, like family physicians everywhere, make less money than specialists - at first. To narrow the gap, the specialists subsidize the PCPs, keeping the family practitioners happy without taking too big a bite from the orthopedists and cardiologists. "I couldn't recruit if I didn't do that," says Dr. Glenn Steele, Geisinger's CEO. "We don't want our family doctors setting up their own radiology clinics...
...Steele decided to fix this, switching Geisinger over to a prix fixe, episode-care model for surgery, starting with the heart bypass. Under the new system, a closely coordinated team of caregivers would be responsible for every stage of a bypass patient's treatment and recovery. The hospital would submit a single bill for all work and include a 90-day warranty. If a patient checked back in with a complication like a postsurgical infection, that work would be on Geisinger's dime. "We'll do it right, or we won't send a bill" was how Steele...
While you might not need a computer to tell you that an 80-lb. 4-year-old needs to lose weight, it helps when the same system also warns about a food or drug allergy or a missed measles vaccination. When a child Grauso-Eby treats goes to see a specialist, that doctor will see the same chart, and an alert will flash if the two doctors are prescribing drugs that adversely interact. The chart will track the kid throughout life - for the orthopedist or cardiologist or obstetrician he or she sees in later years. (Watch TIME's video "Uninsured...
Running the Numbers For doctors, lawmakers and anyone else embroiled in the health-care-reform debate, the question is, Can a system like Geisinger's go national? The short answer: in some ways it has. Pay-for-performance, episode care and global coverage have been seeping into health plans for a while...
Geisinger's financials are undeniably rock-solid: the system pulls in about $1.5 billion per year from its premiums and from other insurers, and it has a AA credit rating. But part of that is due to the similar solidity of its patient base - a homogeneous population with a predictable range of ills. The financial team prefers things this way and has resisted any calls for expansion. "We've purposely stuck to our knitting in central Pennsylvania," says Dr. Duane Davis, chief medical officer of Geisinger Health Plans. But larger plans trying to serve more-diverse communities don't have...