Medicare is involved in dozens of experiments in ways to cut costs and improve care. The ideas came from 10 regional meetings, attended by more than 4,000 patients, patient advocates and health care providers.
With healthcare expected to eat away at everyone's retirement savings, encouraging this kind of thoughtful experimentation could be a retirement planning boon to all of us. Here are a handful of these experiments that seem to promise significant improvement and savings if they succeed.
Community-based care transitions. Some 33 percent of Medicare dollars are spent on caring for people in hospitals. Of that, $15 billion a year is due to patients being readmitted within 30 days after they had been sent home. Some $12 billion of those readmissions are considered preventable. This program targets these. It offers a financial incentive for hospitals to work with community health organizations to make sure that once a patient leaves the hospital, he gets appropriate care so he won't end up back in the hospital bed.
Independence at home. Intuitively, it seems right that keeping chronically ill patients at home is better for the patients -- as well as being cheaper. This program will offer chronically ill patients a complete range of in-home primary care services, including home visits from physicians and nurse practitioners. (Remember when docs made home visits?) The goal is to reduce the need for hospitalizations, improve both patient and caregiver satisfaction, and lower Medicare costs.
Health care innovation awards. This program gives money to test some of the best individual ideas. For instance, a group of communities in California got more than $11 million to train about 7,000 home-care workers so they can provide more sophisticated care. If the program succeeds, it is expected to save Medicare $24 million a year. A Delaware health care system received $10 million to computerize the records of patients with a history of heart disease so they can be treated appropriately immediately upon reporting ongoing problems. The financial payoff is only about $375,000 over three years, which makes the payback about 80 years, but saving lives is priceless.