Inside This Issue - Opinion
New approaches to health care long overdue
November 5th, 2012
The walls that have demarcated areas of responsibility within the U.S. health care system are beginning to crumble, as payers, providers and patients seek better ways to ensure quality care and, at the same time, limit expenditures that are the highest in the world, consuming almost 18% of GDP. As both employers and providers, mass market retailers are helping drive that evolution.
Roundy’s Supermarkets, whose 160 grocery stores in three Midwestern states generate some $4 billion in annual sales, has teamed up with Anthem Blue Cross and Blue Shield and Aurora Health Care to better meet the needs of its employees and their dependents in Wisconsin.
Under the insurer’s new Blue Priority program, Aurora will provide coordinated care to those individuals through its 1,500 physicians, 172 clinics and 15 hospitals in the eastern part of the state. Aurora and Anthem will share clinical information, co-manage care and establish quality benchmarks to measure patients’ progress.
Functioning as an accountable care organization, Anthem and Aurora will strive to do away with inefficiencies in health care delivery, resulting in meaningful cost savings for Roundy’s workers. An Anthem spokesman says that, on average, such programs yield savings of 10%, and that lower cost trends usually accelerate as the positive impact of coordinated care accumulates with the passage of time.
“Roundy’s leadership has been looking for a way to more effectively help employees stay healthy,” notes Anthony Fioretti, executive director of business development at HNI Risk Services, who helped put the program together. “With Blue Priority and the Aurora Accountable Care Network we can do just that. This brings true innovation to the marketplace.”
Walgreens is another retailer rethinking the health care paradigm. A recent change in the rules governing Medicare highlights the value of its WellTransitions program. A federal law that took effect on October 1 made it possible for hospitals with high readmission rates for Medicare patients to be hit with financial penalties. Government projections indicate that about 2,200 health care facilities could face fines of some $125,000 each during the next 12 months.
Incorrect use of medications is a major cause of hospital readmissions, and Walgreens WellTransitions is designed to address the problem before it starts. Working in tandem with the hospital, the drug chain offers a range of services, including a review of patients’ medications at the time they’re admitted and discharged; bedside delivery of prescriptions, along with patient education, for use after leaving the hospital; medication counseling for both patients and caregivers; regular follow-up calls; and round-the-clock support via telephone or the Internet.
Washington Adventist Hospital in Takoma Park, Md., is one of the growing number of facilities where WellTransitions is already up and running. Of the first 48 high-risk patients to take part in the program there, only three were readmitted within 30 days of leaving, according to a hospital spokesman. If that success is replicated on a large scale as Walgreens and other pharmacy operators roll out offerings like WellTransitions, the impact will be significant indeed.
Studies cited by Walgreens show that almost one out of five Medicare patients are currently rehospitalized within 30 days of being discharged at a cost of some $25 billion to the health care system.
That kind of performance makes it clear that new approaches to health care delivery are long overdue.