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The need for broad preventive care initiatives is well documented. In June
2003, the New England Journal of Medicine reported that only 55 percent of
recommended preventive care is administered, and only 52 percent of recommended
screening is performed. According to the Centers for Disease Control and
Prevention (CDC), chronic diseases, such as heart disease, cancer and diabetes,
are the leading causes of death and disability in the United States, accounting
for seven of every ten deaths and affecting the quality of life of over 90
million Americans. It is estimated that annually in the United States over $33
billion in medical costs and $9 billion in lost productivity due to heart
disease, cancer, stroke and diabetes are attributed to diet. Furthermore, in
2000, healthcare costs associated with physical inactivity were more than $76
billion. Lifestyle change and screening to detect chronic diseases early in
their course, when they are most treatable, can save many lives. People who are
physically active, eat a healthy diet, do not use tobacco, and practice other
healthy behaviors reduce their risk for chronic diseases and have half the rate
of disability than those who do not.
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MDVIP was established to assist physicians in providing a dramatically greater
emphasis on preventive care than that which can be offered in a traditional
primary care setting. In a traditional primary care practice of 2,500 patients,
a physician who desired to provide a preventive care physical examination to
each patient would spend approximately 2,500 hours, or one year, attending
solely to such exams. Logistically, such a practice could not be viable, as the
physician would not have time to treat acute or chronic illness, and would
further lack the time to develop wellness recommendations based upon the
examination results.
In contrast, MDVIP-affiliated primary care physicians address this inability to
deliver practice-wide preventive care by limiting the size of their practices
to a maximum of 600 patients. The reduced practice size allows time for the
provision of comprehensive preventive care services to all patients, and also
affords the time required to address chronic and acute conditions. These
services include an extensive risk factor assessment; a detailed preventive
care physical examination, with laboratory testing and screenings related to
mental status, exercise, nutrition and sleep; a wellness plan based upon the
results of the examination that can be implemented by physician and patient
throughout the year; and a wallet-sized CD-ROM containing patient history,
physical examination summary, lab results, EKG, and other related information.
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Preliminary studies of MDVIP-affiliated practices have yielded quality of care
measurements that far exceeded national averages, with reduction in
hospitalization rates of greater than 30 percent relative to national averages.
Additionally, an MDVIP study of hospitalization data regarding Medicare
beneficiaries and commercial insureds participating in all MDVIP-affiliated
practices in Florida during 2003 and between January 1, 2004 through August 31,
2004, evidenced significantly reduced cost of hospitalizations and shorter
lengths of stay relative to regional averages, notwithstanding above average
patient acuity. Given the foregoing Health Plan Employer Data and Information
Set (HEDIS) and utilization data, MDVIP believes that an upcoming national
study of all MDVIP-affiliated practices will yield comparable results of higher
quality measures, lower hospitalization rates, shorter hospital stays, and
reduced costs, across the current population of 50,000 patients who receive
care from MDVIP-affiliated physicians.
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On July 6, 2005, MDVIP announced the creation of the MDVIP Committee on Cost
Reduction through Preventive Healthcare which is being chaired by former U.S.
Department of Health & Human Services Secretary Tommy G. Thompson. Together
with MDVIP, Secretary Thompson will be emphasizing the need for expanded
utilization of preventive care services, such as those provided by MDVIP
affiliated physicians, by patients, corporate employers and insurers as key
tools in reducing morbidity and mortality from disease, enhancing quality of
life, improving delivery of healthcare and lowering overall healthcare costs.
Secretary Thompson has noted that it is essential that the nation reorient the
delivery of primary care to prevent illness at the front end, instead of
spending untold billions of dollars for treatment at the back end. He has said
that the ability to stem the dramatic growth of healthcare costs is directly
related to the ability of patients to obtain, and of employers and insurers to
provide, far broader preventive care options than those that exist today. MDVIP
is currently working with Secretary Thompson to improve the lives of patients
as well as the economics of this nations healthcare system.
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