How Does Patient Centered Care Make Health Insurance More Affordable?

How Does Patient Centered Care Make Health Insurance More Affordable

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These days, everyone is looking for ways to lower their health insurance costs. One of the proposed solutions is healthcare reform, but its eventual effectiveness remains in doubt. Another method of making coverage more affordable focuses on the root cause, as opposed to the symptoms: patients' health.

According to an increasing population of medical professionals and activists, patient-centered care is the solution. It begins with primary health care, and consists of services being coordinated to improve the health status of patients.

Granted, the Obama administration's health insurance reform bill hints towards these elements in several provisions. The idea of expanding coverage is related to the goal of allowing Americans greater access to primary care, before their conditions require expensive specialized care.

Unfortunately, many believe that the law will inadvertently reduce access to coordinated primary care. If the reimbursement rates paid to doctors are pressured downward to decrease premiums, a significant percentage of doctors may choose to close their practices or change to more lucrative specialties.

A pilot program in Maine seeks to create financial incentives for such doctors to remain in primary care, which is necessary given the existing shortage (that is predicted to become even more dire in the near future). The Patient-Centered Medical Home project will have health insurance companies reimbursing doctors for participating in the effort; the additional work includes improving coordination of medical records, decreasing appointment waiting times, and reducing wasteful duplicate tests by communicating with a patient's other health care providers.

The additional pay should encourage more physicians to get involved. So far, four pediatric practices and 22 adult practices are participating in the Maine program. According to the program's supporters--including the Robert Wood Johnson Foundation (which has pledged a $50,000 grant for the next three years), the Maine Health Management Coalition, the Maine Quality Foundation, and Quality Counts--the increased personalized attention provided will ideally prevent patients from falling through the cracks.

Presumably, the improved health status of patients will result in affordable health insurance, since "an ounce of prevention is worth a pound of cure".

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