An apple a day might keep the doctor away. But it also lowers their profits.
From a business standpoint, doctors have had little financial incentive
to promote wellness.
But some changes to Medicare policies could leave local health care providers
reaping benefits from keeping patients out of the office.
“It really is moving from sick care to health care,” cardiologist
Dr. Rick Lewis said.
And a new health care association has signed up to participate in a Medicare
program which aims to keep health care costs down.
Mary Washington Health Alliance is one of 89 new accountable care organizations
throughout the country that have been chosen to be part of the Medicare
Shared Savings Program.
They are among 405 ACOs serving more than 7.2 million patients, according
to a news release from the Centers for Medicare and Medicaid Services.
Mary Washington Health Alliance is a partnership between Mary Washington
Healthcare and about 400 local physicians. That partnership started in
2013, when MWHC—which operates two hospitals and a standalone emergency
department—wanted to create an alliance.
That alliance first became the network of providers for MWHC’s employees.
This year, the alliance will add about 18,000 patients. Those new patients
will be Medicare beneficiaries who already use a doctor in the alliance.
Medicare beneficiaries who use doctors outside of the alliance would not
be affected, said Travis Turner, vice president of clinical integration for MWHC.
And those with doctors in the alliance will notice little change, said
Lewis, who is the alliance’s medical director. The alliance’s
doctors will share medical information to analyze local health care. Doctors
hope to use the data to discover common health problems and seek solutions
to them, Turner said.
The alliance will have to meet quality guidelines set by the federal health
care program. And the group will be able to share any savings the ACO
creates for Medicare.
The alliance is the only Medicare Shared Savings Program in the area, Turner said.