Healthcare delivery the Seattle way

City's large corporate employers contract directly with providers
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Aerospace giant Boeing wants cost savings to take flight via two large accountable care organization (ACO) efforts with Seattle's biggest providers.

Boeing has entered into ACO arrangements with the Providence-Swedish Health Alliance and UW Medicine, which operate Seattle's biggest hospitals, Healthcare Finance News reported. About 30,000 employees and retirees were enrolled into the two ACOs in about equal numbers. The enrollees were attracted by same-day appointments, access to test results and other services via cellphone and the elimination of co-payments for primary care visits and generic drugs.

Results are set to cut costs for care, primarily through the reduction of hospital readmissions, as well as the management of congestive heart failure and other chronic conditions.

"The track is to take care of communities directly," Joseph Gifford, who oversees Providence-Swedish's ACO efforts, told Healthcare Finance News. "It does require us to spend money on innovative care. The framework we're putting in place, this is a model for the future of healthcare. By our ability to coordinate care better for a population, we feel we can reduce the cost of care through better care coordination. Everyone is interested across the U.S. Our phone is ringing from employers."

The initiative is part of a potential new trend, where providers cut out the middleman and contract directly with providers for care, a practice White House healthcare adviser Ezekiel Emanuel, M.D., said was the "wave of the future."

Seattle is apparently a nexus for pushing healthcare quality initiatives. Other large employers based in the area, such as Starbucks and Costco, have reimagined healthcare in the guise of efficient, nearly assembly-line like delivery, according to the Los Angeles Times.

Working with Virginia Mason Medical Center in Seattle, they have focused on streamlining costly process, such as treating back and spinal pain without necessarily resorting to a costly imaging service or even costlier fusion surgeries. Typically, treatment of back pain starts with an immediate appointment, anti-inflammatory medications and physicial therapy, and then will progress to an MRI. Prior to that, patients with back pain may have had to wait a month or more to see a doctor.

"They said this was a supply chain issue," Robert Mecklenburg, M.D., who oversees Virginia Mason's work processes, told the Los Angeles Times. "They expected certain standards from their suppliers. We were no different."

Moreover, the greater use of physicial therapists ran about $1 a minute, compared to $4 a minute for physicians.

To learn more:
- read the Healthcare Finance News article 
- check out the Los Angeles Times article

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