In search of model be­hav­ior

New pay­ment ap­proaches seek to ad­dress flawed fee-for-ser­vice sys­tem

Modern Healthcare - - SPECIAL FEATURE -

There are many con­tribut­ing fac­tors to these high and es­ca­lat­ing costs and in­con­sis­tent qual­ity. The National Busi­ness Coali­tion on Health, along with its 54-pur­chaser-led busi­ness and health coali­tion mem­bers and other like­minded or­ga­ni­za­tions, ar­gue that the cur­rent fee-for-ser­vice sys­tem by which physi­cians are

Ac­cord­ing to an ar­ti­cle in the Septem­ber is­sue of the Har­vard Busi­ness Re­view, Har­vard pro­fes­sors Robert Ka­plan and Michael Porter make the case that we are us­ing the wrong pric­ing model. In­stead of fo­cus­ing on the rea­sons why costs are go­ing up (i.e. grow­ing in­ci­dence of obe­sity and chronic dis­ease), we need to mea­sure ex­actly what we’re pay­ing for. The au­thors main­tain that by an­a­lyz­ing costs of an episode of med­i­cal care, providers could squeeze sig­nif­i­cant in­ef­fi­cien­cies from cur­rent care pro­cesses.

Mod­els for pay­ment re­form

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