Workers and retirees currently choosing their health-care plans for 2012 know this too well: The trajectory of health-care costs continues skyward. The forces at play are varied and complicated, but two encouraging moves by local providers aim to combat the trend in practical ways.
The bigger of the two was the announcement earlier this month that the parent organization of Providence Regional Medical Center Everett and Swedish Health Services would form a partnership aimed at lowering costs while improving performance and increasing community access to care.
Details of the alliance, which would create a regional, nonprofit health-care system, await state and federal regulatory approval. Amorphous as the plan is so far, we’re optimistic about its potential for making services unique to Providence or Swedish more widely available, and generally for creating cost efficiencies by reducing unnecessary duplication.
Both need to improve their balance sheets for the long term. Providence, for example, is projected to provide around $69 million this year in “charity care” — a combination of free or discounted care and unfunded, government-sponsored care — according to Providence Everett’s CEO, Dave Brooks. That’s $17 million more than last year, due mostly to a loss of some $15 million in Medicaid payments because of state budget cuts.
Consolidation should create opportunities to combine administrative resources and other overhead, and potentially by reducing high costs for new medical equipment through increased sharing.
The other encouraging local move was the announcement in September by The Everett Clinic, which serves approximately 37,000 Medicare patients, that it will require them to enroll in a Medicare Advantage plan by Dec. 7. (Some patients are exempt; primarily those with employer-funded retirement medical plans that don’t include one of the Medicare Advantage plans the clinic accepts.)
About 17,000 of the Everett Clinic’s Medicare patients already are enrolled in such managed-care plans, which focus on wellness and prevention, and are designed to lower the overall cost of health-care delivery.
They encourage better coordinated care and more effective disease management, both of which have been a major focus at The Everett Clinic for years. Rather than paying providers based on the number of procedures performed, as traditional Medicare does, Medicare Advantage plans reward providers for keep patients well.
That should be the goal of health care — to keep patients healthy, not just to care for them after they become sick.
The Everett Clinic is hosting free information sessions about Medicare enrollment and Medicare Advantage plans. To register, call 1-888-685-5111 or visit www.everettclinic.com/medicare.