This is the first "medical services" or "management services" product developed by a Permanente Medical Group (SCPMG) for the marketplace. ORC gives Permanente physicians opportunities to improve treatment outcomes, improve cost structures, and implement new technology and methods of dialysis care. Looking at the longitudinal costs of care, investing in programs and people to make patients better will result in healthier patients at time of dialysis, keep patients healthy during the dialysis years, and enable patients to receive a transplant. A healthy patient consumes fewer resources, creating resources for treatment of other conditions.
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"The water is building behind the dam," because despite high levels of members' overall satisfaction with their health plans, the American public has heard managed care horror stories and are looking for comprehensive patient protection. The dilemma is that the comprehensive approach in legislation "invites death by a thousand nibbles." If managed care reform is passed by Congress this year, look for single-issue, less complex bills, such as a definition of "medical necessity."
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