The Missouri Foundation for Health provided a report titled “Bending the Health Care Cost Curve in Missouri” to Missouri lawmakers in mid-April. The report pointed out that medical spending in Missouri is expected to rise faster than the national average in the next decade. Annual health spending in Missouri is predicted to double to $90.3 billion by 2021, up from $46.9 billion in 2011.
Even though health care spending is high in Missouri, the state doesn’t do as well as it should on health performance and quality measures according to the report. Missouri ranks 41st in healthy lives, 30th in access to care and 28th in avoidable use of hospital care.
The report recommended options the state could take to lower cost and increase quality over the next ten years. Here are a few of the recommendations.
Mandate managed care for patients eligible for Medicare and Medicaid. The managed care should help to better control chronic conditions. Savings = $2.7 billion
Focus on disease management. Adopting a team approach and evidence based guidelines would help prevent services being duplicated i.e. blood work by a primary care doctor, more blood work by a specialist and even more if the patient is admitted to the hospital. Savings = $3.2 billion
Broaden the scope of practice for nurse practitioners. Currently nurse practitioners are limited to practicing within 50 miles of their supervising physician. In a rural state such as Missouri this limits the area a nurse practitioner can help offset a provider shortage. Savings = $1.6 billion
I don’t know if any of these recommendations will be implemented but a billion here and a billion there and all of a sudden you’re talking real money!