Sunday, March 17, 2013

Partnership Between Chronically Ill Patients and Their Providers the Way of the Future


Marshall Kettelhut, who lives with the challenge of managing a multitude of serious conditions such as diabetes, heart failure, chronic obstructive pulmonary disease, obesity, high blood pressure, sleep apnea and irregular heartbeat — as well as bouts of anxiety and depression, frequently gets sneak peaks into how chronic diseases will be managed in the future.


As an enrollee in a special program at Seton Total Health Partners in Austin, Texas, for patients who most frequently use hospital services through the emergency room or hospitalizations, he now works closely with a team comprising of a medical staff, caseworker, dietitian and social worker to manage his conditions.  In the six months since his enrollment in the heart-focused section of the program, he has visited the ER once and has been hospitalized once.  His hospitalizations are down sharply from seven in 2011  and three in 2012 and nine ER visits in 2011 and 11 in 2012.
Kettelhut’s story reflects an emerging shift in medical care from the fee-for-service model to bundled payments that reward providers for improved patient outcomes.  It encourages the use of electronic medical records for better care coordination and increased attention on the sickest patients to curb costs.  Under this system, providers receive a lump sum to manage patient care across specialties and settings instead of reimbursements for each service they deliver.
Read more about Marshall, the program and new approach here

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