"I just want them to pay for an episode of care. 'You give me the money we will get them better.' It is a small amount of money but it helps us to get closer to solvency," Waller says. "This is not a clinic built to make money but to save money. What we are trying to do is make sure that it is a sustainable business model. Right now we have a three-tiered payment system. We get $700 for an easy patient, $1,400 for a medium patient, and $2,100 for a difficult patient. And that covers everything. It saves a ton of money."
The center has kept detailed data on the program.
"The goal is to come up with a screening tool so we can identify them on visit No. 2 to the ED and get them the social or psychological or medical services they need before they turn into high frequency use," he says.
With the implementation of the Affordable Care Act, Waller says Spectrum's model could provide an affordable way to control healthcare costs for that high-usage population.
"One of the biggest issues is how do we create comprehensive care and still pay your bills? If you try to create comprehensive care in every doctor's office you will lose your shirt," he says.