Advocates: Preventive care key to cutting costs
By Joshua Riley • GANNETT NEW JERSEY • February 18, 2009 • Asbury Park Press
http://www.app.com/article/20090218/NEWS01/902180374/1004/NEWS01
NEPTUNE — A new health care model that provides doctor reimbursements and other incentives for preventive and aggressive chronic-disease treatment must be adopted as the cost of treating mismanaged, preventable diseases is becoming overwhelming and often unnecessary, some experts say.
Representatives of the Partnership to Fight Chronic Disease, who met with the Asbury Park Press editorial board Tuesday, made this case, saying $7.5 billion is spent annually on the treatment of preventable diseases in the state. The partnership is composed of more than 100 patient, provider and community organizations, business and labor groups and health policy experts.
With health care reform on the Obama administration’s agenda, the organization is fighting for universal health care access, which would include prevention and treatment of chronic disease.
Last year, state Sen. Joseph F. Vitale, D-Middlesex, sponsored the legislation that now provides universal health care to residents under the age of 18, and he hopes New Jersey will provide universal care for all uninsured residents by 2011.
David L. Knowlton, president and CEO of New Jersey Health Care Quality Institute, and Donald Sico, president and CEO of Donald Sico & Co., a public relations company, told the editorial board that the partnership is promoting prevention programs and appealing to politicians to include in any reform bill programs to combat chronic disease.
“Where the money is, is in preventing these things (diseases) or treating these things aggressively, early, so we are not paying for them down the road,” Knowlton said. “(The partnership) said, “Let’s put this out front and center and show people how much money is on the table.’ ”
If insurers changed their policies, the costs of treating preventable ailments such as pulmonary and heart disease and diabetes, which account for 50 percent of the state’s spending on chronic health diseases, would fall dramatically, he said.
There are many models throughout the state that are getting good results and should be replicated elsewhere, Knowlton said. In one program in Camden, Dr. Jeffrey Brenner — who Knowlton said was the only family practitioner in the city — used data from a hospital emergency room to find frequent users of its emergency services and took more than 30 of them into his private practice.
One of Brenner’s patients, who was homeless, obese, asthmatic and diabetic, had been in the emergency room more than 150 times in a three-year period. Brenner made sure the man had a proper inhaler, and could get and use his medications regularly, Knowlton said. Brenner also worked with social services to get him into a homeless shelter, which now has support groups for people with chronic diseases, Knowlton said.
This one patient saved the system millions of dollars in health care costs by ending his use of emergency services, he said.
A person with even one of these diseases will enter the emergency room frequently if they are not getting proper treatment between visits, Knowlton said. They will keep ending up in the ER “unless you work prospectively with these people, and try to attack the chronic disease early,” Knowlton said.
Knowlton said that Brenner’s practice could be used as a model.
As of now, Knowlton said, insurance companies do not reimburse doctors for this sort of social work or other preventive care, which, in the long run, would save the insurers and taxpayers huge sums of money.