New York Times Examines Washington Disease Management Program
The New York Times on Wednesday examined an "innovative" program in Whatcom County, Wash., that uses electronic health records and assigns special nurses to patients with diabetes and congestive heart failure to help them better manage their diseases. The "shared care plan" is "considered a model for how health care can be improved" because it reduces health care expenses and improves the quality of care. Patients who have to see several physicians and take multiple medications are no longer responsible for informing each physician of the drugs they are taking and complications they have had because they are listed on their EHRs, which physicians, patients and their families can access and update. In addition, nurses known as clinical care specialists assist severely ill patients by attending doctor visits with them, answering questions over the phone, teaching them how to better manage their diseases and improving communication between physicians and patients. The program has reduced doctor visits, medical complications and costs. In addition, patients in the program with diabetes have lower glucose levels, and patients with congestive heart failure have remained stable.
While the program benefits patients and insurers, each physician participating in the program "stand[s] to lose at least $2,000 a year, according to projections, and some doctors repor[t] that their costs are already much higher," the Times reports. To participate in the program, physicians must purchase the EHR systems. In addition, they are asked to provide services that substitute for individual doctor visits -- such as e-mailing with patients and holding group office visits -- but are "poorly compensated, if at all," for those services, according to the Times. "I've been in practice for 25 years and I've made less money this year than I ever did before," Dr. Bertha Safford, a participant in the program, said. However, she added that she would not abandon the program when the county's grant ends this year because it has improved care. CMS Administrator Mark McClellan said the program is "very promising" but added, "Often, financial incentives are set up to reward more office visits and more complications. We will have a lot easier time if we can improve our financial incentives" (Kolata, New York Times, 8/11).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.