Our dysfunctional American healthcare system is incredibly dis-coordinated; it’s worse than watching guests try to dance (badly) at a reception.
Part of this dysfunction is that healthcare has been a perfect place for niche services to thrive – companies which specialize in one specific area or service that is a small piece of a person’s healthcare treatment. These for-profit niche companies tend to crop up and take advantage of our nation’s dis-coordinated health insurance system.
Niche is Nice… for Niche
In a dis-coordinated system, niche services (specialized in one area) work great: they get the job done at a volume discount price, members get the product or service they need, and often a small business makes a profit.
In a dis-coordinated system, it’s OK to have separate and cheaper services provide their bit for health. The less expensive health risk assessment data is held in one shop, the cheaper biometrics data is held in another shop, and the convenient worksite wellness program is held in yet a third shop. The member can go to each individual shop and get the individual benefit.
But in a coordinated and integrated healthcare system, these niche markets are unnecessary, and maybe even dangerous. They certainly don’t promote an integrated primary care home.
Coordination is Cool… and Improves Care
Barbara Starfield, MD has studied the benefits to primary care all over the world and here in the United States. Bottom line: coordinated primary care works.
Coordinated primary care gives better overall treatment to most people for most of their problems most of the time. Primary care coordinates information through a personal relationship to improve health, decrease cost, and improve the patient’s experience.
But primary care won’t work as well in a dis-coordinated environment.
There are dozens of goods and services that get niched and sold by vendors to unsuspecting and well-meaning health insurance companies, employers, and patients.
- Health risk assessments
- Wellness programs
- Disease management
- Health screening/ health fairs
- Patient education
- Text messaging
- Care coordination
These vendors can make each of their niche goods and services cheaper. But when they aren’t provided in the context of a personal relationship with a patient’s primary care provider, they don’t really save money. The information they collect has to find its way to where it belongs: with the patient and their primary care provider. Getting it there is expensive, time consuming, and fraught with mistakes, duplications, and omissions.
Colorado HealthOP is Coordinated
Colorado HealthOP invests in coordinated primary care. We believe this investment will pay off with improved member health, lower costs, and happy members. That’s what the research shows, and that’s what we aspire to.
Does Colorado HealthOP use niche services? Yes, but carefully and with coordination. With careful consideration of the impact on the member and provider, we weigh the risks and benefits of each niche vendor. We have chosen some products and services; we have rejected some products and services. We work diligently to make sure the vendors, products, and services we do use are directly aligned with our goal for coordinated primary care. This takes extra work, time, and resources – but it’s that important. We strive to resist the urge to jump on every niche product that might save us some money this year. That’s because we are investing for the long-term and want to help build a more sensible, coordinated system of care for our members.
On that note, we’d like to finish by saying a little coordination can be a beautiful thing for everyone.