Showing posts with label fee-for-service. Show all posts
Showing posts with label fee-for-service. Show all posts

Saturday, January 12, 2013

NYC Hospitals Chart Move Quality-Based Compensation for Physicians

New York City Ties Doctors' Income To Quality Of Care by Anemona Hartocollis.  The New York Times.  January 11, 2013.

In negotiations with physicians, the administrators of New York City's Health and Hospitals Corporation which runs the nation' largest public health system hope to incorporate quality measures in doctors' paychecks.  Such a action would be in keeping with the broad national trend away from rewards for volume of medical services and more toward quality of service.  The article contains several  interesting observations about who such a system could be "gamed."  For example studies of quality- based systems have shown that while measured quality service improved, unmeasured quality service declined.

Thursday, December 6, 2012

Program Tests New Approach to Treating Medicare/Medicaid Eligible Poor

Medicare-Medicaid Experiment Aims To Save On Care by Mary Agnes Carey and Sarah Varney/Kaiser Health News.  USA Today.  December 5, 2012.

California is experimenting with moving a large group of Medicaid enrollees from traditional fee-for-service programs into managed care to see if good care can be delivered at lower cost.  This program foreshadows the roll-out of a program under the Affordable Care Act for managed care for dual-eligible  people i.e. those eligible for both Medicare and Medicaid.  These dual-eligibles face some of the most complex medical cases from both programs.  The challenge is for better coordination to eliminate costs and deliver better service.  Critics site concerns regarding the speed of implementation and scope of the new program.  While there is an opt-out provision in the national program, critics wonder how that would work when a significant number of the affected patients have cognitive impairment.

Wednesday, October 24, 2012

A Model for the Future of Medicine

Kaiser Permanente CEO on Saving Lives, Money.  USA Today. October 24, 2012.

In this interview with George Halvorson, chief executive of Kaiser Permanente, the largest managed care company and hospital in the nation, he offers his many interesting observations including:

*Because we are prepaid, we don't make our money by having care go wrong.

*Most of (our competitors)...don't get paid for prevention.

*We buy our surgeons by the month, not by the cut.  (Physicians at KP are on salary eliminating any possible incentive for unnecessary surgery).

*We need to stop rewarding the infrastructure of American health care for making mistakes.

Fascinating article about a firm that many view as a model for the future of U.S. medicine.