Is Kaiser the Future of American Health Care?

“In Northern California alone, Kaiser spends $55 million a year on chronic-care management programs. “But what’s really expensive is if we don’t take care of these people and manage their chronic conditions,” said Dr. Robert Mithun, chief of internal medicine at Kaiser’s medical center in San Francisco.

Dr. Mithun’s comment may seem like no more than common sense, but it does not reflect the typical logic of the dominant fee-for-service model of health care. Most doctors and hospitals get a fee from insurers for each patient visit, clinical test, surgical procedure or day a patient spends in a hospital. In practice, the fee-for-service system is often an invitation to do more of everything – more visits, more tests, more surgery. What gets done is what gets paid for, and insurers usually do not pay for preventive care or chronic care management provided by nurses or in group classes, like the ones at Kaiser.”

How true. Insurers are moving away from preventive measures instead of embracing it. In the long run, the focus on prevention will be key in controlling costs.