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| Posted: April 7, 2009 |
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A Pennsylvania hospital system is testing a new payment system -- a "warranty" model in which patients and insurers pay up front for an operation and any necessary follow-up care. A hospital executive and a health policy expert discuss the model, and other health policy innovations. |
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| Fred of Arlington, Pa. asks |
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| This warranty sounds good, but is it good for a person without insurance? |
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| Ronald Paulus responds: |
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 Geisinger's ProvenCare program clearly does not, by itself, solve the very important and difficult problem of covering the uninsured. With that said, the principles of the program would indeed apply directly to the uninsured. First, the exact same clinical process steps are applied to each and every patient regardless of his or her insurance status -- Geisinger Health Plan, Blue Cross, Medicare, Medicaid or uninsured. Second, for those paying fully for their own cost of care, the "warranty" as you phrase it would be of particular importance as the uninsured individual is "on the hook" for the full amount of the fees. More broadly, Geisinger looks forward to working with all constituents to try to solve the problem of the uninsured for all Americans.
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| William Scanlon responds: |
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 Persons without insurance are the ones at most financial risk if complications occur. The warranty provides a form of protection against those costs. What lies behind the warranty should also benefit someone without insurance. The risk of complications should be lower. The warranty is based on research to identify how the risk of complications with a procedure can be reduced. The warranty is then offered only when that research is used to guide care providers to take the steps that reduce the risk of complications.
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