Improved continuity of care could save billions of dollars, study says

Streamlining the continuity of care among Medicare patients could save the United States hundreds of billions of dollars a year, has reported.

That's the conclusion of a Johns Hopkins University study published in the July edition of JAMA Internal Medicine, which examined the medical records of 1.2 million Medicare patients from 2008 and correlated them to 19 medical procedures that are considered overused. At least 14 percent of those patients received at least one medical procedure that was not necessary. However, those patients who received care that was in greater continuity (with fewer providers) were less likely to receive nine overused procedures, six overused diagnostic tests and three therapeutic procedures.

Max Romano, a medical student at the Johns Hopkins University School of Medicine and the study's lead author, concluded that improving continuity of care of Medicare patients could save the program as much as $600 billion a year without any erosion in the quality of care being delivered, according to Romano noted that the average Medicare enrollee has 13 medical visits each year. Those visits are within four different medical practices, split among an average of two primary care physicians and five specialists.

Good continuity of care also contributes to better health outcomes. A study published last year linked solid care continuity to decreased cardiovascular events and related deaths. And better continuity of care after a hospitalization can often reduce readmissions within 30 days of discharge. However, some emerging trends in healthcare delivery--such as retail clinics--can sometimes upset care continuity with primary care providers.

Better continuity of care in this study does not solve every problem. reported that those patients whose continuity of care were above average still received three overused procedures: Digoxin monitoring, MRIs of the lumbar spine for low back pain, and thorax CT scans.

To learn more:
- read article 
- check out the JAMA Internal Medicine study