The last thing anyone wants are needless trips to the doctor, more lab
tests and prescriptions, or — on the other end of the spectrum —
to end up repeatedly in the emergency room after ignoring health problems.
These scenarios are symptoms of what’s wrong with health care in
America today. They also drive up costs.
Many people just aren’t good at keeping up routine checkups and
making healthy lifestyle choices; some don’t want to; and others
simply don’t have the money to make their health a priority until
they face a medical crisis. As a result, doctors and hospitals end up
practicing sick care rather than health care.
However, there’s a movement afoot to change these dynamics across
the nation, and it’s taking hold in the Fredericksburg area. A growing
number of local general practice doctors and specialists are joining the
Mary Washington Health Alliance so they can improve care while cutting
costs for needless lab tests, prescriptions and treatments. Using information
technology and encouraging physicians to employ evidence-based best practices
also saves money for patients and government programs such as Medicare
and Medicaid. So far, about 400 independent doctors—family practitioners,
specialists and caregivers at Mary Washington and Stafford hospitals—are
coordinating patient care and providing follow-ups for high-risk patients
so they don’t end up back in the hospital. Though the health care
business is competitive, we hope the alliance will encourage many more
area doctors to take part.
The local alliance is one of about 400 “accountable care organizations”
in the United States now. It’s the first in the Fredericksburg area
and one of eight in Virginia.
“Its goal is to respond to changes in the health care industry.
How better to do that than partner the health care system and local physicians?”
Travis Turner, the alliance’s vice president of clinical integration
told The Free Lance–Star’s Cathy Jett.
Patients shouldn’t notice anything different, Turner says, but it
makes it easy for physicians to access additional information and improve
outcomes. Doctors and nurses can better coordinate care for heart disease,
cancer, diabetes, arthritis, obesity and other chronic ailments.
In the past year, the fledgling alliance here has reduced the cost of
caring for the 50,000 people it serves—employees in self-insured
plans, such as at Mary Washington and Stafford hospitals, and Medicare
patients. Their total cost of care decreased 3 to 4 percent through November
compared with 2014.
That’s an impressive reduction. Total health care spending nationwide
has increased 4.4 percent this year, the Peterson–Kaiser Health
System Tracker reports.
The Centers for Medicare & Medicaid Services count on alliances to
improve the quality of care and control costs for the Medicare system.
In fact, accountable care organizations that do so earn performance payments.
We hope the local alliance and others around the nation will be a game-changer
for both patients and health care providers.
“I think anybody who has to deal with the crisis of health care
costs realizes that something has to be done,” Dr. Thomas O. Janus,
who chairs the alliance’s board and is the founder of Rappahannock
Family Physicians. “The system as it stands right now is unsustainable.”
We trust the alliance will stem the rising costs of health care and improve
people’s lives by providing area doctors with the information they
need to offer the right care at the right time.