Will 'Coordinated Healthcare' Save San Francisco Millions?

Dr. Kildare.jpg
Tommy, first let's collect some 'metadata'
When multimillion dollar businesses adopt language and sales strategies befitting used car dealers -- or worse, Crazy Eddie -- consumers would be wise to clutch tightly to their wallets.

Well, tomorrow the city and a bevy of its health providers will announce a grand plan that "ensures no rate increase for the City and County of San Francisco." How can our health providers do it? Because they're CRRRRRRRRRRRAAAAAAAAAZZZZZZY!

Er, actually not. Actually it's a "coordinated care" health model in which large amounts of data sharing reveal inefficiencies within the system; a pilot program in Sacramento saved taxpayers some $20 million in 2010. Now it's coming here.

During the 12-month course of this agreement, the city is, again, "guaranteed" to not have its healthcare premiums go up from July 1 until at least a year later. And if they do -- the city's healthcare providers have promised that they'll make up the difference (Bad credit! No credit! Even bankruptcy!).

"Coordinated care" is an amorphous term. Here's the Reader's Digest version: Health care providers, doctor's groups, and hospitals -- Blue Shield, Brown & Toland Physicians, California Pacific Medical Center, Catholic Healthcare West, Hill Physicians, U.C. San Francisco -- are going to be sharing reams of data.

City workers probably aren't enthused by the notion that lots more people will be eyeballing their charts. They may yet vent their spleens -- but that's not covered under the plan.



Their concerns can be somewhat assuaged, however, by the fact that the data involved here is "metadata." Rather than pointing out that Larry the airport janitor has a cholesterol problem, the Sacramento pilot program discovered, for example, an alarming number of elective knee surgeries and hysterectomies. Counseling doctors to first offer less invasive -- and expensive -- procedures saves money.

Ideally, San Francisco employees won't find their lives much affected by the changes to come. Data will now be shot from primary care physicians to hospitals -- and back to primary care physicians after patients undergo operations. A city employee who finds him or herself in an out-of-network hospital during an emergency will be automatically tracked, and moved as soon as he or she is stable. Patients leaving the hospital will have their appointments with primary care physicians automatically booked.

It remains to be seen how much the "coordinated care" of the 26,000 San Francisco employees, dependents, and retirees covered in this plan will save the city. The Sacramento pilot covered some 41,000 employees and had fewer moving parts: In Sac-Town, only one hospital system and physician group were involved. Here in the city, the plan encompasses two physician groups and three hospital systems.

Those in the know tell SF Weekly the city could certainly save several million dollars -- and perhaps even something in seven digits. 

Who knows -- this could be the rare San Francisco cost-saving program that actually saves costs. That'd be CRRRRRRRRRRRAAAAAAAAAZZZZZZY!

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