Markets at Work: MA Plans Compete in Florida
The scene at Leon Medical Centers’ Healthy Living Facility in Miami on a recent Thursday resembled a cross between a luxury hotel and a theme park.
White-gloved doormen wearing porter uniforms ushered elderly patients from white vans into a gleaming lobby with colored terrazzo floors and a bubbling fountain. Greeters in green vests and ear bud radios welcomed the Medicare members and made sure their doctors knew that they’d arrived. Refreshments were proffered: Would they like a cafecito and pastelito for the wait?
And that was just the entranceway. Three more floors of the sprawling center bustled with Leon members meeting with physicians or dentists, taking healthy cooking classes, exercising in the fitness center or learning to use Facebook in a lecture hall…
With so many providers in one place ― most of them salaried employees of the center ― [Benjamin Leon, Jr., founder of the center] says members can shorten the time between primary care physician referral to specialist to diagnosis.
“What takes six to eight weeks,” he said, “we can do in 3 1/2 to four hours.”
But Leon also holds down costs by managing patients within the center’s network of providers. Fewer referrals to outside specialists means bigger savings for Leon, particularly important as Medicare Advantage cuts are phased in. He said the plan has not eliminated any benefits for 2014.
Source: KHN/Miami Herald.
This is where I get a little dissatisfied with Medicare Advantage. Although the plans work very well at co-ordinating care for chronically ill individuals, these stories indicate that the risk-adjustment mechanism still causes plans to select healthier individuals.
In my post yesterday, asking whether Obama can bail out the insurers, risk adjustment came up as a topic in the comments. This story shows how difficult it is to achieve accurate risk adjustment.
That sounds great as long as it isn’t coming out of my pocket.
If the government gets its way, then it will.
“Hospitality, they’ve discovered, is good business.”
Especially when dealing with older people.
True. Money, a high time preference, and an appreciation for comfort.
The problems start showing up when congresspeople go there and ask, “Why can’t all healthcare be like this?”
“But Leon also holds down costs by managing patients within the center’s network of providers. Fewer referrals to outside specialists means bigger savings for Leon, particularly important as Medicare Advantage cuts are phased in. He said the plan has not eliminated any benefits for 2014.”
I’m glad that this option is available, although I wouldn’t expect it be able to stay like this for long. Medicare is about to be decimated.
I’m in favor of experimentation as long as the results help both taxpayers, patients and the health plan that is looking for ways of building a better mouse trap.
“”What takes six to eight weeks,” he said, “we can do in 3 1/2 to four hours.”” Sign me up!
Now that’s healthcare in style.
Its something I could really get behind.
Oh Jeeves! Bring me my champagne and heart medicine!
This is an interesting post, I wonder to what extent this will be emulated in other parts of the country given that pretty soon 80 million baby boomers will be retiring.
One could say that of course insurers will treat their customers well, if the federal government is giving them an average of $13-$14,000 per patient per year.
The amount could be more than that with prospective risk adjustment.
Dr Goodman said years ago that insurers who take on less healthy people should be paid more. I am not sure if he meant that Washington should be doing the paying.
Having reviewed the comments, especially Devon Herrick’s, I think I’d like to modify my first comment somewhat.
While I am still not thrilled that taxpayers are paying for pastelitos and cafecitos (whatever they are: I prefer coffee and donuts), this story shows them going along with high quality and time savings.
In this case, it is not (just) risk selection, especially if patients have legitimate needs to see a specialist.
On the contrary, the comforts are ways of signalling these other attributes (quality and time savings) which would otherwise be difficult for patients to observe accurately.
Similarly, the best doctors in private practice in NYC, for example, signal quality by paying high rents for plush offices in mid-town Manhattan. This suggests high quality to patients.
This is observed in other professions (lawyers, financial advisers), too.