Medicaid in Florida

I just returned from Germany where I attended a conference in Berlin. Read the attached excellent article by John Dorschner online in my hotel room and, what a coincidence, that same weekend an article in a German magazine highlighted healthcare cost control measures within the German universal healthcare system. In my opinion the Medicaid reform measures are doomed to fail as long as physician practices are incapable to measure the quality, outcome and costs of care rendered. The fee-for service model rewards volume above value of care and the participating physicians have no other choice but to apply this doomed treatment paradigm to keep their practices afloat. In a recent New England Journal of Medicine article the authors called for reengineering prevention into the U.S. System to accelerate the transition from Sick Care to Health Care. The Patient Centered Medical Home (PCMH) represents the foundation of such a new approach to health care including reconnecting medicine to public health services and integrating prevention into the management and delivery of care. Furthermore, the utilization of information technology tools within a PCMH allows for the value stream mapping for healthcare delivery to determine if what we spent for healthcare translates into cost-efficient, high quality and patient centered care. Eliminating administrative waste, i.e. insurance companies, is part of the value stream mapping process and must be addressed to transform our highly inefficient sick care system into a patient centered health care model. Bernd