Implications for the Us Economy – Why Healthcare Needs Radical Transformation

...

The Surgery Center of Oklahoma is an example of innovative company embracing free-market principles. SCO is a 32,535-square foot, state-of-the-art multispecialty facility in Oklahoma City, owned and operated by approximately 40 of the top surgeons and anesthesiologists in central Oklahoma. SCO provides what many consider to be the highest quality care in Oklahoma, but with a radical departure from conventional practice in the industry. Surgery Center of Oklahoma operates transparent pricing model. The SCO website allows visitors to click any part of the body and see the all-inclusive price of surgery. By providing a complete list of services offered with a price tag on its website, SCO attracts patients and companies who want to pay for quality care at a lower price point. SCO operates as a cash only business; it does not accept major insurance plans, Medicare, or Medicaid. SCO is designed for consumers with high-deductible plans or employers that are self-insured. SCO prices are much less than the same treatment at neighboring hospitals and save employees a significant amount of money. As treatment prices continue to rise in healthcare, The price transparency allows consumers to comparison shop, and help lower the costs of healthcare.

Aspire

Aspire is trying to make care for people in the end stages of terminal disease more comfortable by employing providers who support the specialty care teams to make visits to the person's home as a way to eliminate unnecessary hospitalizations. Palliative care, unlike hospice care where a person foregoes disease-focused treatments, provides comprehensive care and treatment, care coordination across settings, and shared decision making. Palliative care provides an extra layer of clinical and emotional support focused on providing relief from the symptoms, pain, and stress of serious illness by working with individuals and their families to ensure their specific emotional, spiritual, mental, as well as physical care needs and goals are accurately identified and addressed. Aspire’s specialized physician practices provide patients with an extra layer of support that helps improve their quality of life and allows them to stay at home, where the vast majority of individuals prefer to be.

Aspire employs nurses, nurse practitioners, chaplains and physicians, who are available around the clock to go a patient's home or take a phone call, to complement a patient's existing medical team. There are many patients who have problems that could be managed on the phone or with in-person visits rather than with a trip to the emergency room. By meeting the patient in the home-setting, Aspire’s providers get to know the patient and their families, and build trust that is vital when tough conversations arise or when terminal conditions get progressively worse.

The final 12 months of a Medicare Advantage costs an average $63,000, about 60 percent of which is from hospitalizations. The elimination of unnecessary trips to the emergency room will not only lower the costs of healthcare, but also improve the patient’s quality of life.