Taunya English’s story is part of a project on health care in the states, a partnership between WHYY, NPR and Kaiser Health News.
The federal government has tapped a Delaware County company to help test a plan to improve care and reduce health-care costs for those on Medicare.
Renaissance Medical Management Company is the only firm in the Philadelphia region–and one of only 32 in the nation–selected as a Pioneer Accountable Care Organization.
Chief executive officer Marc Malloy says his company has an 11-year track record working with private insurance companies to improve care. Now his team will do the same for Medicare.
The firm will track patient information automatically to make sure seniors get recommended preventive screening tests such as mammograms or cholesterol checks.
“You really have to demonstrate that you’ve improved quality, first. If you don’t improve quality, but you’ve lowered medical costs, that’s not a model that works,” Malloy said.
Renaissance also will match some patients with a care-coordination nurse. The idea is to help people with chronic health problems, such as diabetes or asthma, to follow doctor’s orders and prevent costly trips to the emergency room.
Malloy says care coordinators become a resource in between visits to the primary-care doctor. For example, Renaissance nurses called patients in the days before Hurricane Irene.
“So when our nurses would call up, under normal circumstances they might be talking to them about where they were with managing their disease,” Malloy said. “But that particular week, we shifted gears a bit and started asking people, ‘Are you ready for the possibility of the power being out?'”
Renaissance will be the assigned care coordination company for about 25,000 Medicare patients.
If the firm can provide better quality care and reduce costs, Renaissance gets a portion of the money saved.