June 29, 2009

Coordinated Health Care: Now There's An Idea!

For the last 3 or 4 years, I've been privileged to be a Trustee at Commonwealth Care Alliance, a Massachusetts non-profit HMO serving dual eligible elderly poor. In this case, "dual eligible" means people who qualify for both Medicare and Medicaid. CCA does great work, but it's always swimming upstream. It gets reimbursed by increasingly low and lower Medicare and Medicaid payments. And let's face it, the elderly poor do not constitute an influential political constituency.

One of CCA's founding Board members is Rob Restuccia. In the early 1990s, Rob founded Health Care For All (HCFA), a non-profit health care think tank and advocacy organization devoted to creating a "consumer-centered health care system that provides comprehensive, affordable, accessible, culturally competent, high-quality care and consumer education for everyone, especially the most vulnerable." You see, Rob believes health care is a basic human right, not a privilege for those who are lucky enough to be able to afford it -- a position with which I wholeheartedly agree. HFCA was a central player in the successful effort to pass the Massachusetts Health Care Reform Plan, which, to date, has brought health care to 97.4 percent of its citizens. Universal coverage is a reality in Massachusetts, albeit a more expensive one than originally thought.

The founders of HCFA and its public interest and very influential law firm, Health Law Advocates, are the alumni who came out of the Dukakis Administration and who continue, with lance in hand, to attack the biggest windmills they can find, and, as the Massachusetts Commonwealth Connector proves, those lances are still sharp.

Rob now runs Community Catalyst, a powerful, grass-roots, national non-profit, active in more than 40 states and dedicated to bringing affordable, quality health care to everyone in America. You've probably never heard of it, but I assure you that the dealmakers on Capital Hill are well-aware of Community Catalyst.

As I have written before, health care within worker' compensation, at only two to three percent of total health care spending, is the tiny caboose on the back of the great big group health locomotive. But workers' compensation medical costs have increased at roughly twice the rate of group health annual increases for a dozen or more years, and most experts agree that the biggest engine fueling the constantly rising comp medical costs is over-utilization, which itself is driven in large part by a lack of coordinated care.

Rob Restuccia's Community Catalyst has just published a white paper on Coordinated Care, Special Delivery: How Coordinated Care Programs Can Improve Quality and Save Costs. This paper does not focus on coordinated care within workers' compensation. Its logically larger aim is to influence care in the other ninety-seven percent of medical spending. However, the absolutely common sense points it makes and lessons it preaches can, and I suggest, should be applied to the world of workers comp.

It deserves to be read by everyone involved in the current health care debate.



Bit of a soft soap on the abject failure of the Massachusetts Universal (socialist) healthcare experiment - just more of what will befall the entire country shortly.


The article and concept and both badly flawed.

The example of why the man with TB died at the beginning of the article not germane. The man may not have died because information that he and his advocates should have had was hidden from him. There is no hint that the outcome would have been different. If that is the best example then there is no problem except getting doctors to do what they should.

Then the definition of coordinated care is an intrusion into every aspect of a patient's life and big brother telling him what to do every minute of the day.

This is very much what many are afraid of in the Government Health plan as promulgated by the current administration and congress.

The government has managed to kill off the traditional family and in doing so have deprived many of the advocates (family members) they need in health care and other areas. That was the job of the extended family and has been for many thousands of years.

There are those who want to replace the extended family with professional advocates which will control peoples lives under the guise of advocacy went it comes down to "We Know Better" elitism.

I have no problem with advocates for those who have no family and are incapable of being their own advocate.

After my own daughter's death I have cultivated and created several relationships with young ladies who will gladly act as my advocate, and are educated to be able to do so capably, should I need it in my older age. I act as advocate and coordinator for my wife who is a hemiplegic stoke survivor.

Please keep your highly overpaid professional coordinators away from me. I choose to go to hell in my own fashion.

Charles Read


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This page contains a single entry by Tom Lynch published on June 29, 2009 7:46 AM.

Health Wonk Review's Confederations Cup Edition was the previous entry in this blog.

Cavalcade of Risk and other news notes is the next entry in this blog.

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