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C4 Project

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Touting the Kaiser model for cutting costs


“Where does the high cost of American healthcare really come from? Mostly it comes from our futile attempts to fend off death. Everyone knows that a disproportionately high percent of your life expenditure on healthcare comes in the last few years of life. ”

“One thing we do know is that people will make better choices when we communicate with them effectively. The C4 Project out of’ Johns Hopkins looked at structured communication with family members of ICU patients involving the entire treatment team. They found that patients and families made their own quality of life decisions when properly informed.”

“The project concluded that a little communication went a long way to reduce futile, unwanted, and costly care.”

“{T]here is  the fact that Americans just get too much medicine. They see doctors when they don’t need to. They get tests and procedures that aren’t necessary. ”

“As always, the best answer to a complex problem draws from many sources. But there are some guiding principles that emerge. First, we need to line up the incentives. Right now, the hospitals, providers, and insurers make money when the patients are sick or perceive themselves to be so. Let’s turn that around. We make money when the patient is not sick. And I don’t mean that we refuse care. Let insurance, providers, and hospitals work together for a common fee. When the patient is healthy the system spends less and we make more.”

“{L]et providers run the system, including the insurance companies, and compete with other providers who are doing the same. Without any wish to canonize Kaiser, they have created an impressive model for this kind of unified care. ”


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