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donkpow

Health care network

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I'm joining a health care network in the local area. It's basically a set of hospitals, clinics, doctors, specialists, facilities, etc. under one name. The network ensures providers have things they need like a current list of active members who take referrals, etc. Here's the good part, all pertinent information is centrally located and accessible digitally by all the network service providers. IOW, a doctor doesn't have to fill out a form and get special consent from a patient to access information from, as an example, a hospital visit. I fill out history and registration documents and they are maintained for the network digitally. It's a pretty good deal for a patient.

My current PCP doesn't want to join a network because it costs too much. She has a portal for access for my information but unless she sends information to the network, nobody but her practice has the info.

I'm going full in on the health care network. PCP and everything.

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We have Kaiser Permanente here (it's a national provider), which I think tries to do what you are talking about. Folks either love it or hate it.  But it does seem a relatively "simple" idea - get all the healthcare stuff you need under one roof with one overall system and with a single payment point.  Efficiency and cost savings built in with some limitation of choice.

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35 minutes ago, donkpow said:

I'm joining a health care network in the local area. It's basically a set of hospitals, clinics, doctors, specialists, facilities, etc. under one name. The network ensures providers have things they need like a current list of active members who take referrals, etc. Here's the good part, all pertinent information is centrally located and accessible digitally by all the network service providers. IOW, a doctor doesn't have to fill out a form and get special consent from a patient to access information from, as an example, a hospital visit. I fill out history and registration documents and they are maintained for the network digitally. It's a pretty good deal for a patient.

My current PCP doesn't want to join a network because it costs too much. She has a portal for access for my information but unless she sends information to the network, nobody but her practice has the info.

I'm going full in on the health care network. PCP and everything.

PCP is bad news.  I watched an after school special about it.  This kid smoked a joint laced with PCP and jumped off the school roof.  I still remember this 40 years later.  

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48 minutes ago, donkpow said:

....Here's the good part, all pertinent information is centrally located and accessible digitally by all the network service providers...

When Taiwan began to modernize and its healthcare system and make it like Medicare-for-all, the commission charged with implementing it looked to the American system as a starting point and, after studying it, came away horrified at the inefficiency, confusion, etc.  25% of American healthcare dollars go to paperwork, both for billing and for information.

ALL Taiwan's medical records are now in a central database. Patients can allow doctors to access it or the patients can limit the information (in case there's a temporary, embarrassing problem they don't want anyone to see) and can store their info on a stick-drive if desired before seeing a doctor.

I thought of that on Monday when my PCP and I went over my every-three-month diabetes-related blood test. He told me to get two printed copies of my lab at checkout - one for me and one for my Endocrinologist - the Diabetes Specialist he originally recommended to me - and to ask her if she is on the same lab database as him so I won't have to carry printed copies to my regular checkups with her if so.

As far as networks go, I'm very fortunate that my county's teachers union pays 75% of the near-Cadillac BCBS Medicare Supplemental that it and the county school system provide for us retirees. So I pay for $134/month for Medicare A & B plus $159/month for the BCBS supplemental medical, dental, and vision insurance. All providers accepting Blue Cross in the State of Maryland, D.C., and Northern Virginia are all in my network and I have BlueCard, which lets me pay network copays out of the network to all who accept BCBS.

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2 hours ago, Razors Edge said:

We have Kaiser Permanente here (it's a national provider), which I think tries to do what you are talking about. Folks either love it or hate it.  But it does seem a relatively "simple" idea - get all the healthcare stuff you need under one roof with one overall system and with a single payment point.  Efficiency and cost savings built in with some limitation of choice.

We love our Kaiser. Docs answer questions quickly on the message system. There is no in/out of network. No lab fees showing up 2 years later for $$$. Make you appt online. See your test results within a couple hours

Honestly if we ever move it will be to an area with a Kaiser system. I have no idea how I would navigate a "regular" healthcare system

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We have two competing entities in our area, Premiere Health and a local company. Each has major hospital sites and several satellite sites around the area; med centers, test facilities, trauma centers, etc. I'm using the local outfit, Kettering Health Network. I started to sign up with Premiere but they consolidated and closed the facility closest to me. Now KHN has the closest facility to me and my recent trips to the ER solidified my decision.

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My wife and I have oncologists in one network and primary care doctor in another network. The two networks fight like little kids. We get our lab work all done in the network our PCP is in and have it faxed to our oncologist.  They won’t share MRI images online so we have to get it on a disc and I have to hand deliver it. That’s a PITA but the diagnostic center up here is fantastic and amazing. Every time we tried using the oncologist’s network for testing they screwed up the billing and we had to fight them for months to get them to code it correctly so our insurance would pay it.

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