A Better Way to Pay for Healthcare

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Bill Gammie
Bill Gammie

By Kathleen Ganster

Keeping the quality in patient care while working with less funding seems to be an overriding theme in health care these days, which makes collaborative efforts between health care providers more important than ever. 

The Affordable Care Act has changed many aspects of healthcare and payment for services is one of those major changes.

“There are numerous payment models that have been put into effect and the changes certainly provide challenges for health care providers. One thing I think most of us in heath care agree upon is that there is a better way to pay for health care,” Bill Gammie, Vice President of Value Based Care at Celtic Healthcare said. 

The traditional payment models in healthcare have shifted to value based models, Gammie explained.  A driving force behind the changes is the financial burden that Medicare has placed on the country. So like it or not, the changes are here to stay. 

“And some of these payment models may mean ‘lump payments’ to one entity for all of the services provided as a patent moved through the various steps in their health care. That has accelerated the focus of how providers are working together to ensure payment,” Gammie said.  

But that is just one reason healthcare providers should have good, joint efforts in providing patient care. 

According to Gammie, the “Triple Aim” as it is well-known by, is the tenet that health care should provide three goals: 1) better health, 2) better health care, and 3) greater value for the dollars spent. 

“There is a reason they are in that order. Better health for our patients is still the most important issue. And by working in collaborative efforts with other providers means a better continuum of health care for these patients,” he said. 

And that produces that first goal of “Triple Aim,” better health, Gammie said. 

“Hospital readmissions and adverse healthcare incidents are lower. By working together, we are being more proactive to reduce these adverse events from happening and that means health care quality is improving,” he said.  

Like any major changes, there have been glitches in those new payment models, Gammie said, but as more analysis and studies are done, he feels sure they will be corrected. 

“I’m sure the first car ever built didn’t go 100 miles-per-hour, but they do now,” he said. 

One thing that has improved is that hospital readmissions are down. Celtic has always prided themselves on their lower than average statistics for readmissions and this is one area that is a definite reflection of better patient health. 

“The improved collaborative efforts means we are seeing even better statistics,” he said. 

Another benefit of the joint efforts for the healthcare providers is that patients see all of their care givers working together with the single aim of keeping them healthy.

“Patients feel they receive better care and feel more connected if they feel everyone is focused on their care. They are happier. That means the overall healthcare experienced has improved,” he said. 

For more information about Celtic Healthcare and how your healthcare teams can work together visit www.celtichealthcare.com