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Better Healthcare: Surgery with a Warranty
by Alan Joel

When you go to your local superstore and buy an mp3 player, it comes with a limited warranty, right? Everything from a toaster to a pup tent comes with a warranty. If something breaks within the warranty period, you take the item back, and the store either fixes the problem or gives you a new one. I know I tend to shop at places that handle warranty issues with a "no questions asked" policy, don't you?

Well, now the concept of warranty is moving into the area of healthcare. At certain places in the U.S., like the Geisenger Health System in Pennsylvania, you now get a warranty with your surgery. Really.

90 Day Warranty on Surgery
Suppose you go in for elective coronary bypass surgery. Your surgery literally comes with a 90-day warranty. What this means is that your insurance company pays a flat rate for the surgery, and you pay the associated co-pay. If any complications show up within the first 90 days after your surgery, and you have to go back into the hospital, the Geisenger Health System pays for the hospital stay and associated procedures. A warranty, after all, is a warranty.

Of course, to make this system work the Geisenger Health System has to do some fancy footwork in advance to ensure that patients don't have complications after surgery. For the bypass heart surgery, director of cardiothoracic surgery Alfred Casale, M.D., worked with a team to create a 40-point checklist of best surgical practices. Every point on the checklist has to be met before the surgery can proceed. If not, the procedure is cancelled. Period.

Rewarding Good Results
The results are stunning. The rate of patient readmission after surgery has dropped by 44% and the result hospital net revenues have gone up by 7.8%. The really neat thing about this concept is that it rewards physicians and healthcare providers for better care, which is the opposite of the current system. For instance, under the current insurance system, if a physician fails to give the patient an antibiotic and complications arise, the patient has to come back to the hospital. The healthcare provider then has a second opportunity to treat the patient, and to bill the insurance company. In a sense, poor care often leads to higher billings. In the case of the warranty, poor care only results in a net loss for the healthcare system. As a result, physicians are motivated to get it right the first time around.

While the concept of offering surgeries with warranties hasn't caught on yet in the rest of the country, it's an idea that is worth promoting. It definitely promotes better healthcare for fewer dollars, a concept that would please not only President Obama, but everyone else who is concerned about the quality and cost of healthcare in this country. That's you and me.

 

 

 

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