Treat sickest, most expensive patients? Is that ethical?

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We are always interested in debates regarding the allocation of healthcare, and here’s a recent story that discusses one doc’s approach. Give it a listen.

In 2004, Master founded Commonwealth Care Alliance. It’s an unusual group that focuses on Massachusetts residents who are eligible for both Medicare and Medicaid. In other words, the neediest, most medically complicated, and most expensive patients in the state. They usually have multiple chronic conditions that mean frequent visits to hospital emergency rooms or intensive care units.

Commonwealth Care has re-imagined primary care for these patients. They get access to doctors 24/7, home visits and an entire, interdisciplinary team of doctors, social workers, mental health experts, etc. to ensure that every aspect of the patient’s life is improved. The results are remarkable. Master’s patients are healthier. They don’t visit the hospital as often, which means in some cases, the cost to treat them has dropped by more than 50 percent.