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Editorial: Improving Health Care For Patients and Payers

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Three projects right here in Albuquerque offer hope for a better health care system in the new year. Better for patients, and better for those paying the bills.

One involves Presbyterian Healthcare Services, selected as one of only 32 participants nationwide in a federal Health and Human Services Department initiative. The Pioneer program, part of Obamacare, is designed to improve care given to Medicare recipients while saving an estimated $1.1 billion over the next five years. A key component is tracking the health and treatment of patients and coordinating care among various providers — with the goal of reducing duplicative and unnecessary (and expensive and frustrating) medical procedures.

Another, announced earlier this year, has Lovelace Health System participating in a national three-year Acute Care Episode demonstration project. It, too, coordinates treatment, this time by accepting one “bundled” reduced payment from the Centers for Medicare & Medicaid Services for inpatient orthopedic surgeries. Goals again are geared toward better patient care: reducing readmission and infection rates, negotiating better prices from medical equipment vendors, improving coordination of care and encouraging standardization of treatment.

And there is Presbyterian’s Hospital at Home program, now entering its fourth year, which gives patients who are sick enough to be in the hospital, but not sick enough to be in immediate danger, hospital care in the comfort and familiarity of their own home. The partnership with Johns Hopkins University includes house calls to give medication, adjust equipment and assess recovery, and runs $1,000 to $2,000 less than a traditional hospitalization.

It’s no secret that health care in the United States is on financial life support. Medicaid is breaking states’ banks (New Mexico kicks in more than $600 million annually as part of the $4 billion spent on the program here). Medicare is taking seniors with it to bankruptcy (a recent study shows women who retired last year will need an average of $93,000 in savings to pay for health care expenses; men will need $65,000 — and that’s with Medicare); meanwhile the program is projected to be insolvent by 2017.

So it’s heartening that efforts are being made to cut those costs without cutting necessary care. Even more so that these programs are being tested in New Mexico.

This editorial first appeared in the Albuquerque Journal. It was written by members of the editorial board and is unsigned as it represents the opinion of the newspaper rather than the writers.

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