Thursday, 01 December 2011 21:00

OpEd: Reducing Health Care Costs In Louisiana

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reitzGreece and Italy could pull the Euro down. A deadlocked U.S. Congress can’t agree on how to address our record deficit. The threat of another recession persists as the housing market fails to rebound and unemployment continues to stagnate.  Wall Street is weak and erratic. The cost of healthcare continues to rise.

 Ready for some good economic news? Market forces in the healthcare sector are combining to address the rising cost of healthcare. In earlier columns, I criticized federal healthcare legislation for failing to address affordability, and stated that – given this important shortcoming – it was the responsibility of the players in the private healthcare sector to achieve what Washington could not.

Over the past year, we witnessed signs here in Louisiana that stakeholders were beginning to embrace the idea of working together to create an affordable system centered on quality.

Now, support for a new, interconnected and coordinated healthcare delivery model has grown into a movement. This movement, called the Patient-Centered Medical Home, is being embraced by physicians, employers and health insurers

Like all good solutions, the Patient Centered-Medical Home is simple. Primary care is at its foundation. Supplied with information from a patient’s health insurer and from the medical practice’s own electronic medical records, a patient’s primary care physician is armed with the data needed to greatly reduce duplicative and ineffective care.

A care coordinator, working at the medical facility, helps the physician coordinate care. The physicians practicing in this new model are compensated through incentives that reward quality care and improved outcomes rather than the volume of services.

Evidence is emerging that the combination of all these elements is beginning to impact the cost of care for patients and employers, and because the model is physician-led, it is gaining wide acceptance in the professional community.

However, even simple, direct models provide challenges at their inception. To help stakeholders meet these challenges, Blue Cross and Blue Shield of Louisiana is sponsoring a series of summits to educate stakeholders and the public on how to set up these revolutionary new healthcare delivery models, and on the positive effects – both in terms of increased quality and cost-savings – they can produce.

The first of these summits will be held December 6 at the Pennington Biomedical Research Center in Baton Rouge. Speakers include Dr. Paul Grundy, president of the Patient-Centered Primary Care Collaborative in Washington, D.C.; Dr. Diane Rittenhouse, a leading health policy researcher and practicing primary care physician; Dr. Brian Demarie, a Louisiana native and practicing physician at the Medical Clinic of North Texas, a nationally renowned patient-centered medical home, and Dr. Ken Phenow, senior clinical officer of Blue Cross and Blue Shield of Louisiana.

I strongly urge all interested stakeholders to attend. Admission is free. For details, go to

by Mike Reitz, President & CEO, Blue Cross and Blue Shield of Louisiana, Baton Rouge 

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