Geisinger plan may be model

By Marcia Moore
The Daily Item

June 15, 2009 11:19 pm

— DANVILLE — A fixed-price plan covering certain medical procedures and three months of follow-up care that Geisinger has used for more than three years was the innovation that caught the eye of President Obama, said Frank Trembulak, chief operating officer of the Geisinger Health System.
Last week, while campaigning for changes in the health care system, the president cited Geisinger, which serves more than 2 million people a year throughout central and northeastern Pennsylvania, as a good example of a high-quality, low-cost health service.
Geisinger officials say patients in Geisinger’s ProvenCare program, rolled out in February 2006, spent fewer days in the hospital, were less likely to return to intensive care and more often returned to their home instead of a nursing home.
“Setting a fixed price for a unit of service has shown to be very efficient,” Trembulak said.
While short on details, President Obama’s push for an open debate about health care reform is a move in the right direction, he said.
“The stark realization is the cost (of health care) is almost at a breaking point. It might be the best time to begin to make a significant change and set a foundation,” he said.
Trembulak said he’s heartened by the administration’s approach to reform.
“Obama seems to be very open to all the constituents,” he said.
Although ushering change in an arena with so many interest groups is “politically daunting,” progress can be achieved with a comprehensive plan that addresses all facets of the issue, including insurance coverage and payment delivery, Trembulak said.
“Having an open debate is the right direction, but on the other hand, have they really connected the dots,” he said.
Obama is proposing a plan that would provide health care coverage to all regardless of pre-existing conditions and offer a basic government-provided insurance.
“It’s a means of driving competition,” Trembulak said of the public insurance option, adding the main concern among providers is how Medicaid payments would be delivered and what the government’s basic plan would include.
“The devil is in the details,” he said.