Fixin' chronic care

An outfit called NewTalk is hosting a 3-day on-line roundtable (today was day 2) on the following question: Chronic care: Do we need an entirely new model of delivery?  The all-star panel includes:

Troy Brennan, Aetna Inc.
Lawrence Casalino, University of Chicago
Susan Dentzer, Health Affairs
Philip Howard, Common Good
Brent James, Intermountain Healthcare
Nancy Johnson, Baker Donelson
Timothy S. Jost, Washington and Lee University School of Law
David B. Kendall, Progressive Policy Institute
Mark McClellan Engelberg, Center for Health Care Reform
Peggy O Kane, National Committee for Quality Assurance
Carol Raphael, Visiting Nurse Service of New York
Arnold Relman, Harvard Medical School
John Rother, AARP
Bruce Vladeck, Ernst & Young's Health Sciences Advisory Services
John E. Wennberg, The Dartmouth Institute for Health Policy and Clinical Practice

The key issues under discussion include both delivery models and payment models.  Seems to me there also needs to be more of a focus on population health and on primary care and prevention, since so much of the disease (and cost) burden is due to preventable conditions.

I heard the following description of an alternative payment system at a recent New England School of Acupuncture function:  In a traditional Chinese village, the local acupuncturist is paid a monthly fee by each of his patents — unless they are sick.  Some version of a system incentivizing providers to keep patients healthy would be a vital component of any reform in this realm.

— David Harlow