doctor and patient

Quality over Quantity

ICS’ Community Care Plus FIDA-MMP emphasizes quality over quantity increasing positive health outcomes for people with Medicaid and Medicare.Close your eyes. Picture your ideal visit with your doctor. What do you see? I am guessing it is not a crowded waiting room, a frazzled doctor with less than 5 minutes to discuss your problems or being sent to multiple locations for tests and not getting back a lot of information about the results. I bet your ideal doctor visit would be a lot less stressful, a lot less rushed and a whole lot more personalized.

It’s hard to find anyone these days, doctor or patient, who does not long for a time when health care was more humane, when doctors had the time to really get to know their patients, when appointment times were not so regimented and doctors could speak plainly without the fear of being sued.

Whether your ideal is a picture of a country doctor with a black bag making house calls or a handsome TV doctor who really listens and goes the extra mile to get you what you need, this is not the world we live in. More and more of us find ourselves in a broken system that is focused on moving people as quickly as possible, getting fractured care with many specialists who do not speak to each other.

Where did it all go wrong? How can we fix it? Enter the federal government! Can the group synonymous with the word “bureaucracy” really bring us a kinder, slower, more human healthcare system?

Recently congress passed a law, the so called Doc Fix Bill, to change the way payments are structured and, in theory, change the way care is provided. Is it “throwback medicine” back to the days we all long for? No. But it is a step in the right direction.

For many years, Medicare has paid doctors for what they do.  Not surprisingly, doctors did a lot of things—ran tests, sent patients to other doctors, scheduled follow up visits—all to create a revenue stream. All of this cost a lot of money but did not seem to help patients’ health. Both doctors and patients have been clamoring for a better system but it can be difficult to stop and turn around a speeding train. The Doc Fix Bill introduced a new payment model that will reward doctors for keeping patients healthy – instead of paying them based on how many tests or other procedures they perform. It is hoped that this model will improve the quality of care and take the emphasis off the quantity of care.

ICS’ new plan, Community Care Plus FIDA-MMP—the Fully Integrated Duals Advantage Plan—has similar goals: to reduce costs while increasing positive health outcomes for people who have both Medicaid and Medicare. This three-year demonstration project has similar thinking to the Doc Fix Bill—emphasizing quality over quantity—built into the plan design.

At its core, FIDA is designed to coordinate care, support health and avoid the unnecessary hospitalizations and emergency room visits that come with a lack of preventative care. FIDA also gives a starring role to the patient by requiring a person centered, individualized care plan.

FIDA is very new, it just started in January and honestly, it’s in the throes of real growing pains, but it is built on a solid premise that people need better relationships with their doctors, more communication, more trust and real coordination of all the services they need to enjoy the best possible health and live as independently as they possibly can.

Medicare is probably the single biggest driver of what happens in insurance, and that influence is only going to continue to grow as more and more of us receive our health care through Medicare. Because it is big and government funded, Medicare is often a testing ground for new ideas that, if they work or save money, are widely and quickly adopted by private and nonprofit insurance companies. As a result, changes to Medicare have a way of impacting all of us over time. So whether or not you are currently enrolled in Medicare, pay attention. Stay informed. Talk to your doctor. Become your own advocate for your own best health.

With demonstration projects like the FIDA and policy changes like the Doc Fix Bill, the Federal Government is actually working hard to be an agent of change and make healthcare what it should be – all about taking care of people.

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  1. […] will accomplish in the next few years, but the goals of FIDA are the right goals. As Loreen Loonie put it a few weeks ago, “We increasingly find ourselves in a broken system that is focused on moving people as quickly […]

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