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Economy

How Ft. Worth Saved on Health Care Costs

2018-10-23

[DallasNews] The city of Fort Worth health plan, which serves nearly 14,000 employees, dependents and retirees, is projected to be $4.8 million under budget for fiscal 2018.

From January through June, spending in emergency rooms dropped 34 percent. Visits to the ER declined sharply, in network and out. Much of the credit goes to a new approach that bets heavily on the value of primary care.
Not sure how that related to Affordable Obamacare.
Three health clinics were opened exclusively for city workers and their families, and five other satellite clinics were added to the mix. Members who see a doctor in those facilities ‐ and wait times are less than five minutes, officials said ‐ don’t have to pony up a co-payment or deductible.

That’s right: Office visits are free, as are about 40 of the most common prescriptions.

If the nearby clinics aren’t convenient, members can call a doctor line for a consultation. So-called virtual visits (via smartphone, computer or landline) are also free for those enrolled in the city’s health center plan.
Sounds like O-Care to me. Not.
Accountable Care Organizations (ACOs) encourage providers to form networks to better coordinate care. They share electronic records, try to eliminate duplicate tests and work with case managers and others to help patients stick with their regimen.

They resemble HMOs except that members are allowed to go outside the preferred network. They just have to pay more ‐ at least $60 for an office visit in Fort Worth’s plan.
But they can keep their Doctor?
ACOs have grown rapidly, starting with Medicare patients and expanding into the commercial market. But many experts were disappointed with the savings in the early years.

The government said ACOs increased Medicare spending by $344 million from 2013 to 2015.
That'd be the ObamaStudy.
But more recent studies, which use a different analysis, reported significant savings from the program ‐ more than half a billion dollars over the same period.

The city wanted employees to get in the habit of going to the clinics first ‐ and paying nothing for a visit.

By early October, the clinics had received almost 9,500 visits. Next year, Fort Worth expects the health plan's costs to come in almost $4 million below budget ‐ with no changes to employee co-pays, deductibles or premiums.

"It's working out wonderfully," Dickerson said.

Posted by:Bobby

#7 It sounds like the majority of the cost savings comes from incentivizing the employees and their families to go to walk-in clinics with salaried medical staff, which is much cheaper than private doctorw who are paid by the visit... or hospital emergency rooms. But this is not new information — the porblem is getting people to give up their own doctors and settle for the anonymous staff of a clinic instead.

On one hand, treatment is faster and less expensive for both patient and insurance company. On the other hand, there is no continuity of care, no single doctor is keeping an eye on each patient’s progress. It’s fine for the vast majority who are healthy people with simple, common medical needs... and dreadful for those with rare diseases or complicated diagnoses, who need their GP to actively manage their cases and stay in top of new scientific developments.

But given the dire current financial condition of most local and state governments, this is probably the best situation they can provide, and the Fort Worth example does allow individuals who need more than is provided to pay out of pocket for their special needs — the difference between a workable situation and Medicare/Medicaid, which as I understand it do not allow going outside what is covered.
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Posted by: trailing wife 2018-10-23 20:36

#6 Of course it isn't "free". Somebody does have to pay for it. Personally this might be a good model for a lot of businesses that offer health careas a benefit or even more local, state or dare we say Medicare. In terms of the future economy of this country health Care is the 500 lb gorilla in the room. It's costs continue to outstrip inflation by a large margin. What's the answer? I don't know. Part of the problem is greed on the part of health care providers. Everybody from hospitals to insurance companies. The other part is the greed on the part of health care users. The "little Johnny has a cold, let's take him to the ER" types. On top of that we have the people without health using the ER as their health care provider causing the the providers to build the cost into everything else

Posted by: Cheaderhead 2018-10-23 17:41

#5 A lady cutting my hair enthused about her European holiday, among other things she gushed about "...and their health care is free!" When I pointed out that "I Isn't 'free' -- someone had to pay for it." the conversation quickly shifted to another topic after a moment of dead silence.
Economic Illiteracy... *SIGH*

Posted by: magpie 2018-10-23 15:46

#4 It actually makes a lot of sense to get a lot of primary care centers that push the wait times down if it encourages people to get looked at early and catch problems early when they can be cheaply treated. ("A stich in time saves nine", and "Time is money".) if the prescriptions are free, then people won't delay taking them. Also note that they have professional pester-ers (I.e. case managers) that get after people to follow their care plan.

I would NOT be surprised, given the high costs of treating complications of diseases that were allowed to grow unnecessarily large, that avoiding two or three bad cases on the back end would more than pay for primary care level treatment of 10 or more at the front end.

However, to fisk the article: note that the health plan was like the health plan for a business whose members, being responsible enough to hold down a job, would be responsible enough to take care of themselves. Get back to me when Also, the out-of-network visit co-pay is steeper than what I would have to pay, which incentivizes using in-network physicians.

Also, there is no direct comparison between what the plan costs versus what the costs would be if they went network-Obamacare: That's not that high a hurdle to clear to be cheaper than O-care.

It was always known that Obamacare relied heavily on primary care physicians to be gate-keepers to the specialists, but the renumeration structure was such that the specialists were paid more, discouraging participation as primary care physicians. The REJECTEES for Medical doctoral programs are not stupid individuals, so that information got fed back into the system pretty quick (An example of the vital need of socialists and leftists to keep people static and not give them freedom to react in a self-preserving manner, since it wreaks havoc with the predictions of the effects of their programs).

Posted by: Ptah 2018-10-23 14:40

#3 At least someone's making an effort at using market type solutions for this sort of thing.

Posted by: Raj 2018-10-23 13:21

#2 P2K - I was thinking the same thing. Some of these services may be at "no charge" to the recipient but funding is coming from somewhere, likely tax dollars. The old saying always applies - "there's no such thing as a free lunch".

Posted by: warthogswife 2018-10-23 11:50

#1 That’s right: Office visits are free

No. Someone pays. It's just another monetary slight of hand trick.

Posted by: Procopius2k 2018-10-23 11:08

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