Phasing out fee-for-service payment.
نویسندگان
چکیده
In March 2012, the Society of General Internal Medicine convened the National Commission on Physician Payment Reform to recommend forms of payment that would maximize good clinical outcomes, enhance patient and physician satisfaction and autonomy, and provide cost-effective care. The formation of the commission was spurred by the recognition that the level of spending on health care in the United States is unsustainable, that the return on investment is poor, and that the way physicians are paid drives high medical expenditures. The commission began by examining factors driving the high level of expenditures in the U.S. health care system. It found that reliance on technology and expensive care, higher payments for medical services performed in hospital-owned facilities than in outpatient facilities, and a high proportion of specialist physicians as compared with generalists were all important cost drivers. But fee-for-service reimbursement stood out as the most important cause of high health care expenditures. The commission then set out 12 recommendations for changing current methods of physician payment. The aggressive approaches that are recommended below provide a blueprint for containing costs, improving patient care, and reducing expenditures on unnecessary care. (The commission’s report is available at http:// physicianpaymentcommission.org/report/ and in the Supplementary Appendix, available with the full text of this article at NEJM.org.)
منابع مشابه
Two Wrongs Do Not Make a Right: Flaws in Alternatives to Fee-for-Service Payment Plans Do Not Mean Fee-for-Service Is a Good Solution to Rising Prices; Comment on “Fee-for-Service Payment - An Evil Practice That Must Be Stamped Out?”
Professor Naoki Ikegami’s “Fee-for-service payment – an evil practice that must be stamped out” summarizes many of the failings of alternatives to fee-for-service (FFS) payment systems. His article also offers several suggestions for improving FFS systems. However, even powerful arguments against many of the alternatives to FFS, does not make a convincing argument for FFS systems. In addition, ...
متن کاملFee-for-Service Payment – An Evil Practice that Must be Stamped Out?
Co-opting physicians to regulate Fee-for-Service (FFS) payment is more feasible and simpler to administer than capitation, Diagnosis-Related Groups (DRGs) and pay-for-performance. The key lies in designing and revising the fee schedule, which not only defines and sets the fee for each item, but also the conditions of billing. Adherence to these regulations must be strictly audited in order to c...
متن کاملHealthcare Reimbursement and Quality Improvement: Integration Using the Electronic Medical Record; Comment on “Fee-for-service Payment - an Evil Practice That Must Be Stamped Out?”
Reimbursement for healthcare has utilized a variety of payment mechanisms with varying degrees of effectiveness. Whether these mechanisms are used singly or in combination, it is imperative that the resulting systems remunerate on the basis of the quantity, complexity, and quality of care provided. Expanding the role of the electronic medical record (EMR) to monitor provider practice, patient r...
متن کاملارزیابی مقایسهای روشهای پرداخت کارانه و سرانه در هزینۀ خدمات بیمهای خانوار: چهارچوب نظری و کاربرد
Background and Objectives: Payment methods of fee-for-service and per capita affect financial incentives of service providers differently, and hence, can produce excess or shortage of healthcare services and expenses for the health insurance organization and the insured. This study assessed expenses of healthcare services for households in the Iranian provinces regarding the payment methods of ...
متن کاملارزیابی شیوه های تامین مالی و نظام پرداخت به ارائه کنندگان خدمات سلامت در کشورهای منتخب: ارائه ی الگو برای ایران.
Introduction: Majority of health systems across the world are experiencing challenges in their performance, quality, equity, and efficacy because financial resources limitation. To deal with, they use different method of financial allocation resources and payment systems. Methods: This comparative descriptive research is dedicated to financing methods and payment systems to the health service p...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- The New England journal of medicine
دوره 368 21 شماره
صفحات -
تاریخ انتشار 2013