Health & Wellness

By Bonvissuto, Kimberly | Medical Economics, December 25, 2012 | Go to article overview

Health & Wellness


Bonvissuto, Kimberly, Medical Economics


How primary care can reshape healthcare economics through preventive medicine

Billions of dollars could be shaved from the nation's annual $2.5 trillion healthcare bill with a greater focus on disease prevention, in forms such as tobacco cessation; alcohol abuse screening reduction of weight, blood pressure, and cholesterol risk factors; and the encouraging of daily aspirin use.

As part of its 2011 National Prevention Strategy report, the National Prevention Council found that

* a 1% reduction in weight, blood pressure, glucose, and cholesterol risk factors would save $83 to $103 annually in medical costs per person;

* annual healthcare costs are $2,000 greater for smokers, $1,400 for people who are obese, and $6,600 higher for individuals with diabetes than are costs for individuals without those conditions; and

* medical costs are reduced by about $3.27 for every dollar spent on workplace wellness programs.

Those statistics, combined with continuing increases in healthcare costs, have sparked greater interest among the nation's employers in wellness services for their workers. In response, some primary care practices are expanding beyond their office walls to bring services directly to the workplace.

Although original workplace clinics provided more occupational health or urgent care services, the trend is moving toward wellness and primary care services. The option provides convenience for the employee and delivers a happier, healthier, and more productive workforce for the employer.

A MODEL PROGRAM

Dartmouth Health Connect is turning the practice of primary care on its head through its new delivery model that promotes wellness. The primary care practice opened in February in conjunction with Dartmouth College in Hanover, New Hampshire, Dartmouth-Hitchcock health system in Northern New England, and lora Health, a Cambridge, Massachusetts, healthcare company founded by Rushika Fernandopulle, MD, MPP, who serves as chief executive officer.

The practice- which is not a walk-in clinic- includes two Dartmouth-Hitchcock Medical Center physicians, a nurse, a practice coordinator, and several health coaches. The primary care practice offers physicals, vaccines, sick visits, prescriptions, and ongoing care to Dartmouth College employees.

Instead of the usual fee-for-service model, Dartmouth pays lora Health a monthly per-patient fee, providing an incentive to focus on patient health, Fernandopulle says. Enrollment is voluntary, but more than 650 patients have signed on to the new program.

lora Health, the successor to Fernandopulle's Renaissance Health, already runs similar practices in several other locations, including in Nevada and New Jersey, where the focus is on casino union workers, and in Seattle, which caters to Boeing employees. He plans to open additional practices in 2013 in Brooklyn, New York, and Boston, Massachusetts. Fernandopulle says the model produces an average net healthcare spending reduction of 20%.

'Our model is, employees don't pay anything out of pocket. It's completely free to them," Fernandopulle says. "We get paid per employee, but unlike concierge care, the employer is paying that They are the ones who will benefit when dollars are saved.

"We are outside the insurance system. We do an end-run around the insurance company. We directly contract with the employer."

PUTTING IT ALL TOGETHER

Fernandopulle says that to change the model of primary care, it is imperative to start from scratch, lora Health designed the practice space to meet the needs of Dartmouth Health Connect, hired a new team, trained health coaches, and even designed its own information technology system, which alerts the practice when patients are having health problems and allows patients to view and enter information in their own medical records.

"People feel it's a better service," he says. When first starting out, Fernandopulle says, he tried what other practices sometimes do: running a standard primary care practice while adding corporate wellness programs at different locations. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Health & Wellness
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.