EDITORIAL

Jul 25, 2010 — The Keene Sentinel

Jul. 25, 2010 (McClatchy-Tribune Regional News delivered by Newstex) -- Several years ago a new term began surfacing in the health administration field: Accountable Care Organization. Definition: a framework by which all the medical interests in a community -- the specialists, the family physicians, the emergency room personnel, the home health care workers, the health insurers and so on -- jointly look out for the health of the local population.

The concept may sound vaguely familiar. In the 1980s and 1990s private insurance companies called health maintenance organizations collaborated with medical providers to assure that care was delivered economically to people who needed it.

But the world of managed care was a fractured one -- medical providers contracted with each insurer one-by-one, so that information about treatments, costs and outcomes was proprietary. Further, the weight of attention -- including reimbursement formulas for care -- was on treating illnesses, not preventing them.

The approach of accountable care organizations is more inclusive; it involves all parties in the health system in information sharing arrangements, and it focuses as much on keeping people healthy as returning sick people to health. In practice, that means more reminders to get check-ups, and more time talking with patients about their overall health.

The holistic approach makes sense. Indeed, the very term "accountable care organization," which is attributed to health policy researcher Dr. Elliot Fisher of Dartmouth Medical School, is cited in the new federal health care reform bill as worth trying.

An experiment of such a system -- one of the first in the nation -- is just now being launched in New Hampshire. The participants include five hospitals, among them Cheshire Medical Center and Dartmouth-Hitchcock Clinic. Ultimately, the participants will also include Medicare, Medicaid and all private insurance networks, plus ancillary players in the health field, including nursing homes, dieticians and other providers.

New Hampshire stands out front on this innovation. Gov. John Lynch has committed the state government to support the networking, for example. And Keene's medical providers are out front, too: a heavily promoted drive by Cheshire Medical/Dartmouth-Hitchcock to make Cheshire County the healthiest county in the nation by 2020 has already involved a number of local collaborations among health care providers.

The big story here is that (1) health care reform, which has so visibly been a national concern through political debate, has potential local solutions, and (2) the main local players are already in the game, and have practiced strategies in mind.

Newstex ID: KRTB-1475-47252289