Inkwell: Authors and Artists
Joe Flower (bbear) Sun 25 Dec 11 09:57
We actually have been having quite a discussion on this very matter elsewhere on the Well. Short version: The devil is in the details, not only the details of just who is paying for what and how they are measuring what they are paying for, but the culture of the providers. It is worth noting that _all_ of the organizations that these new structures and deals are modeled after (Kaiser, Group Health of Puget Sound, Mayo, Geisinger, Cleveland Clinic, Bozeman Clinic) differ in details of structure and payment but have one thing in common: They are old. The youngest ones are about 60 years old, the oldest (Mayo) more than 100. The clinicians working in them have self-selected and been selected to fit that highly collegial culture. How that will work out with clinicians and in environments that did not select out that way will be a matter of great interest and difficulty in the coming years. But it simply must be done.
Nancy Finn (nfinn8421) Fri 30 Dec 11 05:15
I agree with you, changes are essential and these models not only work well but deliver better quality health care for their participants. Let's hope that other organizations see their way clear to adopt the best features and make the changes necessary to provide affordable, patient-centered care going forward.
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