Everybody is in agreement that the country has significant financial challenges ahead.  This is particularly true in healthcare where trends have consistently surpassed inflation.  Most people agree that the current trend of healthcare spending is unsustainable and must be curbed.  When you talk about healthcare reform, there are really two different types of reform.  One is the “Obama care” type reform which is focused on a legal issues, insurance, and coverage.  The other type is payment reform.  Most experts believe payment reform will happen regardless of any other type of reform.
One of the keys to success for future healthcare is clinical integration.  This focuses on both improving the quality of care as well as the efficiency of healthcare.  There are really only three ways to lower healthcare spending.  One is to lower the payments through individual unit cost reductions and payments to healthcare providers.  The second is by decreasing utilization or usage of healthcare.  The third is increasing efficiency in healthcare by moving the patient seamlessly through the system and therefore creating additional revenues to all providers by increasing quality outcomes.
There is no doubt the care in the United States is significantly fragmented.  Most practices are in small groups with 28 percent of physicians in a 3 - 4 physician practice, 14 percent of physicians in a 6 - 10 physician practice and 37 percent of physicians  in solo practice.  There is also very little connectivity across different areas of care from primary to specialty to hospital to post acute.
The critical piece of clinical integration can be defined as “coordination of patient’s care across conditions, provider, setting, and time in order to achieve care that is safe, timely, effective, efficient, equitable, and patient-focused.”  To achieve this noble goal, physicians must communicate across both geographic and functional boundaries.  IT infrastructure must be built to transmit patient information and systems of care must be introduced so that cost can be taken out of healthcare while still providing quality care (while minimizing the impact of reimbursement to providers).
The Continuums Health Partners (CHP in New York City) was able to save $900 per admission or twice as much as physicians who did not participate in the clinical innovation project.
There are many ways to achieve these savings.  This will be critical as we move towards clinical integration with or without employment processes.
This will be the key to increasing efficiency in healthcare while also improving outcomes to our patients.

Presented in partnership by Health Choice, LLC, and Memphis Medical News

www.myhealthchoice.com

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