March 29, 2024
BANGOR DAILY NEWS (BANGOR, MAINE

`Futurist’: Health partnerships will benefit all

BLUE HILL — A forecaster says new health care partnerships in the medical community will benefit both practitioners and their patients.

Described as an author, lecturer and health care “futurist,” Russell Coile Jr. is president of the Health Forecasting Group of Santa Clarita, Calif. The company provides market forecasts and advice to a range of U.S. health care companies.

At Parker Ridge Inn on Saturday morning, Coile addressed officials from Blue Hill Memorial Hospital, Maine Coast Memorial Hospital, MDI Hospital and Eastern Maine Medical Center.

The forecaster advocates Maine hospitals’ following the example set elsewhere in the nation of partnerships with health care professionals.

These “physician-hospital organizations” would integrate their services and finances, creating blocs of formidable market clout.

Without shared strength, doctors and hospitals will be “vendors at the mercy of more powerful HMOs, insurers and government purchasers,” says an article in Hospital Strategy Report, which Coile edits.

According to Coile, trends suggest health care will be delivered by community care networks of hospitals, physicians and insurance partners providing comprehensive services to thousands of enrollees.

Because of package-deal-type arrangements involving high numbers of enrollees, health coverage in those situations should be provided at lower cost, akin to the concept of volume discounts.

Under the capitation system of financing suggested in the Clinton reform plan, preset fees would be paid to providers for all covered health services.

According to Coile, this system would allow physician-hospital organizations more control over how to allocate their resources, and more choice over the types and levels of clinical care they provide.

Coile said managing capitated patients is risky business, with providers losing or making money depending on the results of their own decisions. A provider failing to control its own expenses would not prosper under the system.

Under capitation, a focus on preventive health care would save money, because hospitalization, particularly when illness is advanced, is costlier than an ongoing case management system seeking to maintain health and to minimize acute care.

A greater variety of care facilities and options, including health education centers, home care, hospices and other outpatient services, would help reduce demand for inpatient care by approximately 25 percent.

Coile sees health care reform as a three-phase process. The immediate turmoil characterizing the first phase of planning probably will continue through 1995 or so, with states likely to make the most meaningful decisions on health care.

He said reform is unlikely to prevent the amount the nation spends on health care from continuing to rise, because of its aging population.

Providing universal coverage could take from five to seven years to phase in, despite Clinton’s target date of 1997, Coile said.

“Clinton math” on costs is suspect, said Coile, who holds a master’s degree in health care administration from George Washington University.

“We will never know beforehand the true cost of providing universal health coverage, since we don’t even know how many Americans are uninsured,” he said.

Within the next few years, employers will begin joining purchasing cooperatives to get better prices on insurance, as reform’s second phase, characterized by the forming of new partnerships, gets under way, Coile predicted.


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