Researchers at Washington University in St. Louis have done a study that seems to be about the quality of medical care but could also be about the future of health insurance agents and brokers in a world of big health insurance exchanges, or Web-based insurance supermarkets.
The researchers wanted to see whether actively coordinating patient care would improve the quality of care.
The researchers hired fine people in a call center in California to manage patients’ care, and — nothing happened. Nothing really changed. The patients didn’t get any better. Costs increased 12%.
Then the researchers tried, for the heck of it, to use local coordinators, in St. Louis, and, voila! That worked. The local coordinators reduced hospitalizations 12% and reduced total monthly spending by $217 per enrollee, offsetting the $151 monthly care management fee.
What Your Peers Are Reading
“The results underscore findings from the overall Medicare Coordinated Care Demonstration that suggest that programs with more in-person contacts were more likely than others to build trusting relationships with patients and providers, improve patient adherence to care plans, and address additional needs and barriers that entirely telephonic contacts had been unable to identify,” the researchers say in an abstract of the paper, which appeared in Health Affairs, a health care finance and delivery academic journal.
Maybe the study says something about the exchanges, whether the exchanges materialize because of the Patient Protection and Affordable Care Act of 2010 (PPACA) or because cost-cutting efforts started in the wake of some Supreme Court or congressional action that makes PPACA go poof.