A Health Insurer Pays More to Save

Like a lot of doctors, Patrick Kilduff has too many patients and too little time. He and the five other physicians in Shavertown, Pa., oversee the care of about 12,000 people, and a typical office visit lasts just 15 minutes.

Because health insurers pay him as little as $45 per visit, Dr. Kilduff and his colleagues say they have little choice but to squeeze as many patients as they can into their day. That makes it virtually impossible to spend time explaining to patients the importance of keeping their blood sugar under control or how to take their medicine. But the insurers’ penny-wise approach can lead to as much as $1 million in hospital bills, if a person with under-treated diabetes has a heart attack.

That is why some of the nation’s insurers are now trying to avoid those high medical bills by taking the longer view. They are giving primary care doctors more help — and more money — to take care of the sickest patients and help prevent them from becoming sicker.

Otherwise, insurers know they risk being overwhelmed by rising health care costs as an older, sicker population copes with serious chronic conditions.

“The essential business model of medical insurance will have to change,” said Dr. Glenn D. Steele Jr., the chief executive of Geisinger Health System, which operates a network of clinics and hospitals in Pennsylvania.

http://www.nytimes.com/2010/06/22/business/22geisinger.html?th&emc=th

But, regardless of health care reform, insurance reform, or whatever happens, I don't see anything being done about the coming shortage of doctors in this country. We may need to rely on foreign doctors immigrating, which I don't have a problem with, but I don't think that can close the gap.