On the back of decades of impressive progress in medicine and technology, numerous entities across the United States have looked to change the way healthcare professionals deliver that care to patients. As such, several new coordinated efforts and medical programs have emerged as important means of administering and managing health in an ever-changing world.
Here are five of the most innovative healthcare delivery methods currently in use:
Accountable Care Organizations (ACOs)
A fairly recent addition to the realm of healthcare deliverables, ACOs include a network of hospitals, physicians, and various care providers. These numerous entities collaborate to provide a highly coordinated system of patient care that aims to enhance the quality of healthcare while concurrently minimizing the frequency of medical errors.
As a result, ACOs are not only able to spend their health care budgets more effectively, but they also ensure that patients receive the care they need. Most commonly, ACOs serve groups of Medicare patients who need help organizing a diverse array of medical care. These organizations also work with the wider community, utilizing a broader care process to facilitate care programs dedicated to overall patient wellness.
In addition to placing an emphasis on quality healthcare, ACO programs serve as an initiative for their professional participants. When a group of healthcare providers successfully meets its cost and care goals, all involved parties are able to partake in the subsequent savings. Since its inception in 2012, the concept has grown significantly, with more than 220 ACOs operating in the realm of Medicare alone.
Retail Health Clinics
Over the last several years, retail health clinics have emerged as one of the most important facets of the healthcare industry. An increasing number of patients are choosing to forego visits to their primary care provider in favor of the fast and convenient treatment they can access through these offices. With thousands of retail clinics in drugstore chains across the country, patients can easily see a medical specialist if they need an immediate appointment, do not possess health insurance, or are in another state from their network.
These clinics typically provide a variety of patient services, such as vaccinations and treatment for minor ailments, all within a time frame of about 15 minutes. In addition to these patient benefits, retail health clinics fulfill an important need within the healthcare industry, as they prevent patients from visiting the emergency care for less serious conditions.
In an effort to reduce overall care costs and promote nationwide health, many companies are beginning to offer reference pricing to their employees’ insurance plans. When they adopt this system of payment, insurers limit how much money they will contribute to medical procedures that typically have a wide variation on pricing. At the same time, these pricing plans must still cover enough to provide each patient with adequate options for procedures.
For example, the cost of joint replacement may range anywhere from $12,000 to $75,000 per patient. If a company uses narrow-network health insurance programs, patients will often receive either total coverage for their surgery or no coverage at all. With reference pricing, insurance will generally offer a price cap that lies somewhere near the median price of joint replacement procedures or other required “shoppable” treatments.
This system thus covers the full cost of care at lower-priced medical providers, but only some of the cost with pricier specialists. By offering well-designed reference pricing plans, employers encourage their workers to engage more with the healthcare system and seek better savings without needing to compromise the quality of their care.
A coordinated care effort, bundled payments serve as a middle point between healthcare capitation payments and à la carte-style pricing options. As such, this system aims to provide patients with easier access to a variety of treatments for a single, all-inclusive price.
For example, patients whose health plans include a bundled payment system gain easy access to all facets of hip replacement treatment, including office visits and tests, the operation itself, and rehabilitative care after the procedure is completed. This deliverable thus possesses the capability to transform the healthcare system, as it enables patients to fully outline and establish their own treatment bundles at set prices.
At the same time, the success of this type of program often depends on partnership between healthcare providers and clinics. However, a number of health groups have successfully implemented bundled payment programs for their patients. For example, the Pacific Business Group on Health has proven the system’s effectiveness by sourcing and selecting high-quality clinics and successfully negotiating pricing bundles at the best prices.
Primary Care Medical Housing (PCMH)
Dedicated to revolutionizing the way medical professionals systematize and deliver care to their patients, the PCMH system emphasizes better coordination between the various parties that oversee individual treatment. This ensures that a patient’s primary care physician remains involved in every aspect of their care and can play a key role in delivering the exact care that they need.
Prior to the implementation of this method, physicians often remained unaware of important patient information, such as the number and types of specialists patients were seeing for additional care. Instead, PCMH calls upon these providers to collaborate care with professionals in the medical home, hospital, and beyond.
Also a patient-centered method, the system aims to better educate both individuals and families to help them take part in all facets of care management. Most importantly, PCMH serves as a means of improving the quality and lowering the price of receiving medical care.