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There are places in America where your Medicare dollars are spent more efficiently and effectively. There are places where appropriate end-of-life care is encouraged and delivered with compassion. There are places that could model important elements of health care reform on a larger scale.
Mesa County is one such place.
But don’t just listen to me. Landmark research from Dartmouth College provides important information on health care spending in America. More importantly, it provides clues on how we can provide better medical care at less cost.
Interestingly, the Dartmouth research has found that Mesa County delivers care to Medicare beneficiaries at a cost that ranks near the lowest in the country. The New York Times recently published a story on “Dartmouth Atlas” and the Denver Post followed with a story that highlighted Mesa County’s successes in health care delivery as measured in the Dartmouth study.
More importantly, the landmark work done at Dartmouth indicates a great dichotomy in health care outcomes. Indeed, researches are noting some surprising findings.
The New York Times quoted Dr. John Wennberg of Dartmouth Medical School and chief author of the study as saying, “doctors and hospitals that provided more care, or more intensive care, did not necessarily achieve better results for patients.” In fact, outcomes were sometimes worse with more aggressive care.
Read that twice. These are extraordinarily important findings.
Health care reform experts know that the majority of Medicare expenditures in an individual’s life occur in the last two years of a patient’s life. Certainly, there is much to learn by analyzing the disparate methods of caring for the sickest and oldest amongst the population.
As for cost, the Dartmouth research found that “average per patient spending” in the last two years of life varied widely across the country.
Here are some of the numbers. At UCLA Medical Center, Medicare spending in the last two years of life averaged $93,842. At Mayo Clinic in Minnesota the amount is $53,432. And right here in Grand Junction, the number is $36,000.
As the Denver Post points out, Medicare would have saved $34.3 BILLION over a period of two years if the rest of the country practiced the same end of life care
administered here in River City.
There are lessons for patients and doctors alike. These lessons are critical to successful health care reform. As patients, we should remember that more intensive care is not always better care — and not just at the end of our lives. Similarly, doctors should carefully examine what the evidence suggests: Sometimes doctors push too hard and occasionally to the detriment of the patient.
As we attempt to redesign our broken healthcare system, the Dartmouth Atlas research provides invaluable data. In the United States, some people have little or no access to health care while others are receiving too much care ... and sometimes with worse outcomes.
We will have to provide better care at less cost.
We will have to accept that “more is not always better” in health care.
We will have to squeeze more care for more people out of the same dollar.
We will have to redesign physician reimbursement that encourages evidence based health decisions while discouraging the overuse of technology.
The Dartmouth Atlas study indicates we can save money and still deliver quality care to the American public. In fact, in some cases, we can deliver better care at less cost.
You will hear more about this research in coming years as we struggle with the aging population and explosive Medicare costs. Stay tuned.
<i>Dr. Michael J. Pramenko is a family physician at Primary Care Partners. A graduate of Dartmouth Medical School, Pramenko currently serves on the Colorado Medical Society’s Congress for Health Care Reform as well as Club 20’s Health Care Committee.</i>
Mesa County is one such place.
But don’t just listen to me. Landmark research from Dartmouth College provides important information on health care spending in America. More importantly, it provides clues on how we can provide better medical care at less cost.
Interestingly, the Dartmouth research has found that Mesa County delivers care to Medicare beneficiaries at a cost that ranks near the lowest in the country. The New York Times recently published a story on “Dartmouth Atlas” and the Denver Post followed with a story that highlighted Mesa County’s successes in health care delivery as measured in the Dartmouth study.
More importantly, the landmark work done at Dartmouth indicates a great dichotomy in health care outcomes. Indeed, researches are noting some surprising findings.
The New York Times quoted Dr. John Wennberg of Dartmouth Medical School and chief author of the study as saying, “doctors and hospitals that provided more care, or more intensive care, did not necessarily achieve better results for patients.” In fact, outcomes were sometimes worse with more aggressive care.
Read that twice. These are extraordinarily important findings.
Health care reform experts know that the majority of Medicare expenditures in an individual’s life occur in the last two years of a patient’s life. Certainly, there is much to learn by analyzing the disparate methods of caring for the sickest and oldest amongst the population.
As for cost, the Dartmouth research found that “average per patient spending” in the last two years of life varied widely across the country.
Here are some of the numbers. At UCLA Medical Center, Medicare spending in the last two years of life averaged $93,842. At Mayo Clinic in Minnesota the amount is $53,432. And right here in Grand Junction, the number is $36,000.
As the Denver Post points out, Medicare would have saved $34.3 BILLION over a period of two years if the rest of the country practiced the same end of life care
administered here in River City.
There are lessons for patients and doctors alike. These lessons are critical to successful health care reform. As patients, we should remember that more intensive care is not always better care — and not just at the end of our lives. Similarly, doctors should carefully examine what the evidence suggests: Sometimes doctors push too hard and occasionally to the detriment of the patient.
As we attempt to redesign our broken healthcare system, the Dartmouth Atlas research provides invaluable data. In the United States, some people have little or no access to health care while others are receiving too much care ... and sometimes with worse outcomes.
We will have to provide better care at less cost.
We will have to accept that “more is not always better” in health care.
We will have to squeeze more care for more people out of the same dollar.
We will have to redesign physician reimbursement that encourages evidence based health decisions while discouraging the overuse of technology.
The Dartmouth Atlas study indicates we can save money and still deliver quality care to the American public. In fact, in some cases, we can deliver better care at less cost.
You will hear more about this research in coming years as we struggle with the aging population and explosive Medicare costs. Stay tuned.
<i>Dr. Michael J. Pramenko is a family physician at Primary Care Partners. A graduate of Dartmouth Medical School, Pramenko currently serves on the Colorado Medical Society’s Congress for Health Care Reform as well as Club 20’s Health Care Committee.</i>
