Managed Care

 

With Workplace Clinics, What’s Old Is New

MANAGED CARE June 2009. © MediMedia USA
Editor's Memo

With Workplace Clinics, What’s Old Is New

John Marcille
MANAGED CARE June 2009. ©MediMedia USA

John Marcille

We heard a lot about primary care in the early days of managed care. Gatekeepers were supposed to steer patients to specialists only when necessary, and even limit unnecessary treatment. They still do that, but to a much lesser extent. Remember, we also heard a lot about the Patients’ Bill of Rights. The public revolted against what it perceived as tightly managed care. Just how much gatekeeping actually goes on in health insurance these days would be an interesting research topic, I should think.

We often run articles about primary care, since there is evidence that strong primary care is good for patients and good for payers as well. This issue has a strong focus on primary care — even the factory doc or nurse practitioner, as the case may be.

Our cover story explains how some large employers have decided to get into the primary care business by reaching back to the early days of the Industrial Revolution and setting up onsite clinics. Contributing Editor Maureen Glabman examines the dangers for insurers, but points out opportunities as well.

“The largest employers recognize that cost shifting has run its course, and that is part of the reason for the growth of clinics,” Blaine Bos, a partner at Mercer, the consulting company, told Maureen. Where employers lead, some plans will follow. They may get into the clinic business, and that means primary care.

The medical home is intended to be primary care on steroids, and our story investigates the instruments used to evaluate its effectiveness. Then there are the online physician-only communities, such as Sermo, QuantiaMD, Epocrates, and Medscape, which have opened up a virtual nationwide doctors lounge where physicians (specialists welcome!) can trade advice and sympathy.

Meetings

4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014
HealthIMPACT Southeast Tampa, FL January 23, 2015