No matter what you do, there will always be people who consume more hospital resources than others, notably the chronically-ill poor with spotty access to ongoing care. They’re sicker, over a longer time, and to boot have no way to pay their bills. In that situation, everyone loses.
But is there a way to solve this problem without going broke? Maybe. Here at nextHospital we’ve been intrigued by news of a couple of proposals intended to help patients AND ensure hospital solvency:
* Redeveloping commercial property around urban hospitals and leveraging it to bring a flow of traffic, personnel and physicians to the door. This would bring urgent care/retail clinics, primary care practices and other support mechanisms to the hospital’s doorstep. Ultimately, the idea is to tend to the of the sickest, most expensive patients first — the weakest link, if you will — freeing up more resources to improve care for everyone else.
* Bringing together community healthcare organizations (including hospitals) together into a self-sufficient economic unit which can afford to turn away managed care contracts — and offer affordable care. (See an overview by Dr. Jonathan James of Community MedPAC here: http://www.box.net/shared/65h1c6sax0)
We don’t yet know enough about these models to predict whether they’ll work or not, and to our knowledge, neither has been fully implemented. However, there’s no question that there’s a big payoff, both financially and ethically, for those who can improve access to care while reducing financial strains to the system.
Are there other hospital care financing models which look like they can change the game? If you’ve found any, we’d love to hear about it.