Go outside hospital walls to lower costs

Providing cost-efficient healthcare means moving care delivery outside hospital walls, Kaiser Permanente Chairman and CEO George Halvorson said in a New York Times profile.

Using an integrated model, Kaiser is working to better coordinate care between its hospitals and clinics. And with its own health plan receiving a fixed payment per member, Kaiser has created incentives to keep people out of the hospital.

"We think the future of healthcare is going to be rationing or re-engineering," Halvorson told the Times. Key to re-engineering healthcare for greater efficiency is moving care away from the hospital setting, he noted.

More health systems are opening urgent care or outpatient clinics taking care outside hospital walls, Forbes reported. For instance, Aurora Health Care in Wisconsin runs 37 such facilities, while Intermountain Healthcare in Utah operates 25, the article noted.

Meanwhile, in California, St. Joseph Health, Sutter Pacific Medical Foundation and Marin General Hospital all have announced new clinics since the start of 2013, North Bay Business Journal reported. Through the clinics, the hospitals aim to improve care options and self-management skills after patients leave the hospital setting.

"Upon returning home, between medication changes and new diagnoses, effective treatment strategies can become destabilized, resulting in complications and even re-admissions," Linda Gaudiani, director of the Marin General's new diabetes center, told the Business Journal.

Part of the appeal is that health system-owned urgent care and outpatient facilities guarantee quality physicians, whereas a CVS Minute Clinic might not always offer patients a board-certified doctor, Forbes noted.

In fact, Ohio's Metro Health considers having physicians on the faculty of Case Western Reserve University staffing its outpatient clinics as advantage to both patients and MetroHealth.

"[Patients] want to know that this care is not just one-stop-shopping; it is going to be delivered as a part of their overall healthcare," William R. Lewis, chairman of the market development campaign, leader of the network expansion initiative and chief of clinical cardiology at MetroHealth Medical Center, told FierceHealthcare in a previous interview. "Going to a doc-in-the-box, if you will, is not contiguous care with a primary care physician."

To learn more:
- read the NTY profile
- here's the Forbes article
- read the North Bay article