* By Lauran Neergaard, AP Medical Writer
* On Monday September 7, 2009, 10:04 am EDT
WASHINGTON (AP) -- If you pay the mechanic $1,000 to fix your transmission and it breaks again next week, the garage should find and fix the problem for free. So if you get an infection following open-heart surgery because the doctor forgot an antibiotic, why are you charged extra to clear up the wound?
At Geisinger Health System in Pennsylvania, pay a flat fee for bypass surgery and you'll get essentially a 90-day warranty on your heart fix. Complications? The hospital has to eat the cost. It gambled that following a checklist of best practices would help patients recover faster and cost less -- and so far, it's winning the bet.
It's a radically different approach to a health care system that even many doctors agree rewards volume of care over quality. Yet around the country are hospitals and health systems like Geisinger that President Barack Obama calls "islands of excellence," places quietly trying innovative changes to improve patient care at below-average prices.
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