Death panels and other cheap ways to save money fast

Atul Gawande of The New Yorker is drawing considerable attention this week for his analysis of a 2009 Aetna study on hospices, published in the Journal of Palliative Health, showing the option saves money and is more humane.

The key takeaway was that talking to people who are dying, and dealing with them humanely, can save insurers money and provide what consumers consider a better service.

Whether the hospice was made a standard option or an expensive add-on, palliative care (as opposed to curative care) was seen as very attractive. The study encouraged "comprehensive case management" as a way to increase hospice use.

The bottom line. Offering hospice saves money and eases the final passage.

Unfortunately, this option was taken out of the new health reform law. Opponents called it the "death panel." But the study shows insurers will likely find a way to offer this service, because it boosts the bottom line.

I can speak to this from personal experience. I had a relative who was offered hospice care when it became obvious his disease was fatal. His passing was almost a celebration, in contrast to that of my own father, who died in a hospital alone. What the Aetna study shows is that the first case also cost less, so with insurers now having incentives to save money expect to see more of it.

Another way to save big money is to integrate clinic Electronic Health Records (EHRs) with best practices, especially with regard to drug choices. Nearly $20 billion has been budgeted by the government to improve health IT, and this is one of the definitions for "meaningful use" that will drive the spending.

Take hypertension, for instance. If more doctors knew that niacin supplements from the supermarket could be as effective as a licensed drug version, or that many combination therapies cost less than name brand counterparts, if this knowledge were there at the point of prescription, they would use these options, saving their chronically ill patients a lot of money.

A lot of new money can also be saved with old drugs.

Substances like Misoprostol, once seen only as an ulcer cure, are finding new uses, saving lives as well as money around the world.  The point here is that new breakthroughs don't have to come from new compounds. They can come from finding new uses for old ones.

All this amounts to health reform on the ground. By just being given an incentive to save money, insurers gravitate toward these solutions, just as they're looking to gain more control over their networks, or encourage wellness.

Expect health inflation in the U.S. to slow, relative to that in the rest of the world, as this takes hold. There is an enormous amount of low-hanging fruit when it comes to saving money in American health care, and insurers now have a real incentive to pick it.

This post was originally published on Smartplanet.com