As we began our research toward controlling overall employee benefit plan costs, we began by focusing on employee health. In our research, we became aware of an interesting model of healthcare delivered abroad in Taiwan. Interestingly, the Taiwanese pay their doctor in a similar way as they pay any other monthly bill such as their car payment or house payment. They continue these payments as long as they remain healthy. However, whenever they become sick they stop paying the doctor and receive treatment for free.
Obviously, this system is quite different than our own in the U.S. Ours is a symptom based system, and we in the insurance industry with our “managed care”, and our “negotiated discounts” have forced the US physician to be more of a businessman than we, as patients, would like for him to be. The casualty has been time, education, and follow up with the patient. Patient knowledge has become the critical missing element in the overall U.S. healthcare system. With this premise, we were prepared to test a new model for effectiveness.
In 1997, our firm, along with one of our clients, the City of Asheville, embarked on a quest to test this ’new model’ of healthcare utilizing a format proposed by the UNC School of Pharmacy that utilized pharmacists meeting monthly with high risk patients to train them to manage their condition by providing the education and follow up that is so lacking in our current system. These efforts ultimately received national notoriety and became known as The Asheville Project or Ten City Challenge. In the years since inception, The Asheville Project has been the most studied, documented, peer reviewed, and published , disease management program in the country, and has now been implemented across the entire United States.