209 You Say We're in A Health Care Revolution ...
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Dynamic Chiropractic – May 6, 1994, Vol. 12, Issue 10

You Say We're in A Health Care Revolution ...

Well, Would You Like to See the Plan?

By Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher
Imagine a world where all pertinent information is available to all decision makers; where every aspect of treatment that a patient may receive is kept in that patient's computer file; where each provider is constantly monitored by both peers, payers, and even appropriate government agencies.

Sound impossible? To some extent, it's already happening.

The world of health care is changing.

Where is it going?

What can we expect?

How can we prepare?

These and other questions are addressed in the latest work by well known health care futurist Russell C. Coile Jr. His new book, Revolution -- The New Health Care System Takes Shape, is a look into the immediate future of health care. Although it is written with a focus on medicine, the book clearly defines the forces that are influencing the changes chiropractors are beginning to see.

Consider the following excerpt regarding computer profiling and economic credentialing:

"On the other hand, once these systems are completely functioning, the practice of medicine will take place in an electronic fishbowl. Eventually every medical record will be accessible to payers, third-party review organizations, and government. Computer programs will monitor physician performance in hospitals and offices. Every patient visit, lab report, x-ray, consultation, in-patient stay -- the complete record of clinical treatment -- will be computerized and continuously analyzed.

"Computer profiles of physician performance will compare one doctor with others on a hospital staff, or with peers across the nation. These profiles will be used for privileging, payment, and continuous economic credentialing. Large health systems will be able to centralize their assessment of physicians' performance, using cost and outcomes measures to compare primary-care doctors and specialists throughout the system, so as to standardize quality and cost. Third-party payers, managed-care plans, and self-insured employers will use computer programs to screen out physicians whose cost of care or lengths of stay are consistently high.

"Doctors have good reason to be nervous about economic credentialing. Although few hospitals will have the nerve to drop a physician from the medical staff for any reason other than lapses in quality, HMOs, PPOs, insurance companies, self-insured employers, and even government will reward or punish doctors based on their cost of care. Doctors will economically credential other doctors. Independent practice associations will counsel physicians whose costs are out of line and drop them from managed-care panels if they are not compliant. Hospitals will be looking closely at factors like length of stay, use of ancillary tests from lab and radiology, consultations, number of office or clinic visits for the same patient, procedures, and cost per day. These will all be evaluated and compared from doctor to doctor."

As you can readily see, this is not a book for someone who would rather bury his or her head in the sand and hope that it's all a bad dream. This book talks about managed care, primary care, and all those other nasty issues. Much of what Mr. Coile has to say you may not want to hear, but you need to.

Revolution -- The New Health Care System Takes Shape is only 75 pages. But it has the power to make you better informed and able to truly consider your future in health care. Unfortunately, due to a reorganization by the publisher, they will not be re-printing this book. At last check, there were only 55 copies left.

If you would like a copy of this important work, you may call Whittle Direct Books at 1-800-765-5889 to order one of the last copies. The cost is $21.95 plus shipping and handling; the benefit is substantial.

DMP Jr., BS, HCD(hc)


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