Hospitals joining forces to save you money

by: John Bachman Updated:

ATLANTA —

Two metro Atlanta hospitals are combining resources. Their mission: to make you healthier, keep you out of their beds and save you money. They plan to do all this while making a profit.

Mable Bly is diabetic. She visits Dr. Fayyaz Haq every three months.

If she doesn't, "I end up in the hospital," she told Channel 2's John Bachman.

Avoiding hospitals is Bly's goal. It's Dr. Haq's goal as well.

Hospitals cost the healthcare system a lot of money. Having patients avoid them is also the goal of the Affordable Care Act and other versions of reform.

"Health care reform is coming regardless of whether the Affordable Care Act continues as we know it today," Dan Styf with Piedmont WellStar HealthPlans said.

So if the goal is to keep people out of the expensive ERs and hospitals, then hospitals need to find a new way to make money. That's why Piedmont and WellStar Health Systems are combining to form Piedmont WellStar HealthPlans, the first provider insurance company in the state.

"We need to get ourselves into a position where when our patients win by being healthier, that we win as systems," Styf said.

Now the health systems will make money by monthly premiums, not just with hospital visits.

"The key here is to avoid the tyranny of the visit," Styf said.

Styf said Piedmont WellStar HealthPlans spends more on prevention. That keeps patients healthier, out of hospitals and ultimately saves his company money.

"And we get to practice medicine the way we want, rather than somebody telling us what to do," Haq said.

Haq said it's already working. He told Bachman he is able to spend more time with patients and track their care, making them healthier.

Jack Dillard said the current system needs a checkup.

"I don't know that it can be fixed in my lifetime. Maybe yours, but not mine," Dillard said.

Styf said 50 percent of health care costs are spent on 5 percent of patients. The goal, he said, is to give that 5 percent better care and dramatically lower the costs.