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Poster Child For Coming Health Reform: ‘Better Care Is Cheaper’

For a glimpse of the future of Massachusetts health care as Gov. Deval Patrick envisions it, consider Phyllis Minsky.

CommonHealth’s interview with Phyllis Minsky, whose story suggests big potential savings in health care costs in Massachusetts.

At 82, Phyllis is complex. Medically, that is. Widowed young and veteran of 35 years in the financial services industry, she comes across as a resilient spirit, all backbone and humor and gratitude for small favors. But there’s no denying she’s up against a lot: diabetes, asthma, chronic lung disease, a blood pressure problem that leaves her prone to sudden blackouts. At one point, she was on 20 different medications.

Luckily, Phyllis has a secret weapon these days: Wendy Atamian. A nurse with 35 years of experience, Wendy is Phyllis’s “nurse care manager,” which means that she stays on top of Phyllis’s health: She helps coordinate her doctors’ visits and medications; sets up home-based services after hospital stays; advises her if she’s in pain or can’t sleep. Wendy even suggested a simulator test to help determine whether Phyllis should still be driving.

“Wendy is always there when I need her,” Phyllis said. Together with Phyllis’s primary care physician, Dr. Michael Bierer, “I think they’ve saved me many trips to the emergency room and urgent care” — “which is a blessing.”

15 percent of Medicare patients make up over 75 percent of health care spending.
It’s not just a blessing for Phyllis — it’s a money-saver for the health care system. Older patients with multiple chronic diseases are the biggest consumers of health care; some 15 percent of Medicare patients make up over 75 percent of health care spending. Cutting the costs of their care is a must if the relentlessly rising health cost curve is ever to be bent — the goal of the next phase of Massachusetts reform.

Multiply Phyllis Minsky by 3,200. That’s the number of patients in the five-year-old pilot project that she’s part of, the Mass General Care Management Program. Begun at Mass General, the care management program has now expanded to Brigham & Women’s Hospital and the North Shore Medical Center, for a six-year total of more than 8,000 patients.

And that may be only the beginning.
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