A Little Help From Your (Nurse) Friend

The New York Times reports on an innovative health plan, run by Geisinger Health Systems, that now pays for extra nurses to ease the burden on primary care docs and help patients with chronic illnesses stay on top of their treatment.

The trend toward paying a little more up front to prevent the sick from getting even sicker (which would cost far more down the road)may actually be taking hold. Reporter Reed Abelson writes:

Because health insurers pay him as little as $45 per visit, Dr. Kilduff and his colleagues say they have little choice but to squeeze as many patients as they can into their day. That makes it virtually impossible to spend time explaining to patients the importance of keeping their blood sugar under control or how to take their medicine. But the insurers’ penny-wise approach can lead to as much as $1 million in hospital bills, if a person with under-treated diabetes has a heart attack.

That is why some of the nation’s insurers are now trying to avoid those high medical bills by taking the longer view. They are giving primary care doctors more help — and more money — to take care of the sickest patients and help prevent them from becoming sicker.

So here's what Geisinger does:

Geisinger now pays the salaries of extra nurses in doctors’ offices, whose full-time job is to help patients with chronic diseases stay on top of their conditions and, ideally, out of the hospital. The doctors, including Dr. Kilduff, help hire the nurses, who work closely with the doctors to oversee the patients’ care.

The nurses make sure patients who need quick appointments are squeezed in, and they alert the doctors to any early indications of trouble by keeping in close contact with the patients and looking out for the results of patients’ lab tests.

The initiative is part of an overall effort by Geisinger and other insurers to create a so-called medical home — the place where patients’ care is carefully coordinated by a doctor and staff, with particular attention given to the chronically ill.

This program aired on June 22, 2010. The audio for this program is not available.


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