Long before patient-centered care and value-based models were the order of the day, Geisinger was focused on delivery care that was not focused on figuring out who would pay the bill.
Geisinger Health System, which serves 2.5 million patients in 44 counties across central Pennsylvania, last night premiered a documentary that reviews its approach to delivering care, one whose time seems to have come to the rest of America.
The film played at the F.M. Kirby Center for the Performing Arts in Wilkes-Barre, Pa., and chronicled Geisinger’s rise from a rural hospital in Danville, Pa., to a nationally recognized delivery system with 23,500 employees. According to Citizen Voice of Luzerne County, the documentary outlines how early on Geisinger created a model that focused on treating the whole individual, and being responsible for that patient’s overall health, rather than worrying about finding a third-party payer to pick up the tab.
Geisinger occupies a unique place in healthcare: for many of its customers, it is both the healthcare provider and the health plan. Susan Dentzer, senior policy adviser of the Robert Wood Johnson Foundation, who wrote the documentary’s script served as narrator, explained how this gave Geisinger a more comprehensive view of the entire delivery system.
“That gives Geisinger a unique place where they can experiment,” she said. “What they can do is figure out ways to provide better care that costs less. Often in the healthcare industry, people pay for healthcare on a piecework basis — if you do this to a patient you get a certain amount of money. If you do 5 things, you get this amount.”
Thus, Geisinger is well ahead of most healthcare systems as the nation moves away from fee-for-service toward patient-centered, value-based models that seek to reward physicians for patient outcomes, not for performing procedures.
Dr. Glenn D. Steele Jr., president and CEO of Geisinger Health System, said in his during his 15 years, Geisinger integrated a model in which doctors and hospitals agree to take joint responsibility for keeping patients healthy and sharing in any financial benefits that result.
Unfortunately, fee-for-service still dominates most health systems across the country, which Dr. Steele said gives doctors and health systems incentives to provide more services to patients, even if they were not necessary.
But those days are coming to an end. CMS has made several recent announcements that it will require doctors and hospitals to meet new targets for value-based care in 2016 and 2018. And the proposed replacement to the sustainable growth rate formula calls for rewarding doctors who embrace value-based models.
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