Skip to main content

Atul Gawande: "The Hot Spotters". Healthcare's version of Cash for Clunkers.

In this fantastic piece in the New Yorker, Atul Gawande explains how a community physician in Camden, NJ saved his local hospital millions of dollars by providing very focused free medical care to the patients who were most frequently admitted. Here in DC, the well-to-do pay upwards of $1500 annually to be part of a MD-VIP program, where their primary care physician is available to them 24-7 to address their medical needs. In Camden, the "most dangerous city in America," this physician was able to provide an MD-VIP type of service to some of the poorest and most at-risk patients in America, with astounding results. Gawande writes:
The Camden Coalition has been able to measure its long-term effect on its first thirty-six super-utilizers. They averaged sixty-two hospital and E.R. visits per month before joining the program and thirty-seven visits after—a forty-per-cent reduction. Their hospital bills averaged $1.2 million per month before and just over half a million after—a fifty-six-per-cent reduction.  
What are the keys to reducing costs in healthcare? Focus on the small population of uninsured who have many chronic medical conditions, and who frequent the hospital the most. One study showed that "frequent users comprise 4.5-8% of all ED patients but account for 21 to 28% of all visits." These are the patients where a relatively small amount of free but focused preventative care can result in a dramatic reduction in medical complications and healthcare costs.

I call this idea "healthcare's version of cash for clunkers" not to deride patients, but to emphasize where our efforts need to be most focused. When the US government wanted to reduce auto emissions, they realized that removing a single inefficient polluting old car from the roads had the same impact as trying to make marginal efficiency improvements in 10 newer cars. The conclusion was clear: it's efficient and logical to spend your money where you will have the most impact. The same applies in healthcare. Managing the chronic conditions of our poorest and sickest patients with focused caring preventative care costs much less managing the complications of those conditions.

Comments

Post a Comment

Popular posts from this blog

Dr. Alex Mohseni invited to speak at Brault’s Healthcare Leadership Forum about the future of Emergency Medicine services and how ED groups can adapt using telemedicine.

  Dr. Mohseni presented on the topic of how Emergency Medicine groups could expand their scope of practice to the virtual space to and how to do so in a financially viable way.
Post a Comment
Read more

Information about Medicare Advantage plans, coverage and benefits

Information about Medicare Advantage plans, coverage and benefits is available on this website, Medicare Advantage Information . Some topics covered include: additional benefits for medicare additional medicare benefits medicare advantage blue medicare advantage blue cross medicare advantage blue cross blue shield advantage c medicare advantage care plan medicare advantage cost medicare advantage d medicare advantage dental plan medicare advantage health care plans medicare advantage health plan medicare advantage insurance medicare advantage insurance plans medicare advantage of medicare advantage plan advantage of plan advantage plan insurance advantage plans with dental advantage policy advantages of medicare advantage advantages of medicare for all advantages of original medicare benefit medicare
Post a Comment
Read more

How to connect openai to zapier to twilio so that you can interface with GPT3 via SMS

 I created an SMS interface to openAI's gpt3 API so that I can send an SMS prompt to openai and get an SMS response. Result looks like this: There may be better/easier ways of doing this, but this is how I figured it out. I'm assuming some degree of familiarity w/ Zapier here: 1. Buy a phone number in Twilio to use for this. This only costs $1/mo 2. In Zapier, create a new zap where the trigger is "Webhooks by Zapier" (Premium option). Choose your event as "Catch Hook". This will generate a webhook URL that is custom for this workflow. We are doing this because when you send the SMS to the Twilio phone number, you want it to **instantly** trigger the zapier workflow and not wait the 5-15 min it takes for Twilio to trigger on its own, so for that you need the webhook: 3. Copy the webhook URL from zapier and paste it into Twilio in the "A Messages Comes In" webhook section for that phone number 4. You will then need to send a test message so that Zap...
Post a Comment
Read more