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Spectrum Health Targets ED Frequent Fliers for Primary Care
"I just want them to pay for an episode of care. 'You give me the money we will get them better.' It is a small amount of money but it helps us to get closer to solvency," Waller says. "This is not a clinic built to make money but to save money. What we are trying to do is make sure that it is a sustainable business model. Right now we have a three-tiered payment system. We get $700 for an easy patient, $1,400 for a medium patient, and $2,100 for a difficult patient. And that covers everything. It saves a ton of money."
The center has kept detailed data on the program.
"The goal is to come up with a screening tool so we can identify them on visit No. 2 to the ED and get them the social or psychological or medical services they need before they turn into high frequency use," he says.
With the implementation of the Affordable Care Act, Waller says Spectrum's model could provide an affordable way to control healthcare costs for that high-usage population.
"One of the biggest issues is how do we create comprehensive care and still pay your bills? If you try to create comprehensive care in every doctor's office you will lose your shirt," he says.
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Comments are moderated. Please be patient.
Deb McMaster (8/31/2012 at 8:09 PM)
This shouldn't be considered a one-size fits all approach. Therefore, assumptions should NOT be made about individuals that are taking prescription pain medications.
Ryan Nastaj (2/9/2012 at 1:17 AM)
Those os you who have posted, and there are currently two ahead of me, have not read the whole story behind this movement, This Dr. is a life saver, trust me when i tell you this, becuase i happen to be a patient there at the Integrative Medicine Group, the article left out the following, Dr. Waller is a Pain Medidcine Specialist, and addiction specialist and Emergency Room Doc also. The place doesnt only treat addictted patients to narcotics etc..it serves as a place to start then they transfer you to a regular primary doctor etc..So what the article said was he is an addiction specialist, thats is true but also treats Chronic pain and they do have other staff from network 180 which is a community or a place for the community to go for mental health , addiction stuff etc..when you go in you meet with several different people, from net 180 , dr. waller, a nurse, etc.. and they target your issues form various aspects. So thisis not just a place for addicts...just thought id let you know the truth
Cathy Martin (1/25/2012 at 9:23 AM)
I applaud Spectrum's concept. I think it will provide a very proficient way to ID patient's that will benefit from the program and give a very holistic approach to their care. However, I would caution that a program of 6 weeks is still in a honeymoon phase. I am a very "the glass is half full" person, but I don't belief that in 6 months to a year you will be seeing a sober rate as stated -"More than 90% have stayed clean since they started treatment here," he says. I would be interested in an update on the program's progress at 6 months and one year. I am hoping that Spectrum will share their program as a model for others and have great success with it as well.