OVERVIEW
The current system of payment does not reward physicians and hospitals for improving quality or lowering costs, but encourages the inefficient use of resources and even waste. As long as the U.S. continues to spend significantly more per capita than other countries without producing superior outcomes, there is a powerful need to scrutinize how the incentives and rewards in the health care system can be altered to produce better value.
The current system of payment does not reward physicians and hospitals for improving quality or lowering costs, but encourages the inefficient use of resources and even waste. As long as the U.S. continues to spend significantly more per capita than other countries without producing superior outcomes, there is a powerful need to scrutinize how the incentives and rewards in the health care system can be altered to produce better value.
CORE CPR ACTIVITIES
CHALLENGES
While there is significant momentum aimed at reforming the payment system, several noteworthy issues exist:
- No ‘Silver Bullet’: While experts agree that there is no ‘silver bullet’ for reforming payment, there is no
clear strategic framework supported by key stakeholders that can be used to collectively advance the effort.
- Limited Knowledge of Best Practice: The value demonstrated by current efforts has been limited
because most performance payments are small and well below the cost of change.
- Lack of Coordination: There is a lack of coordination within the private sector and between public and private sectors needed to effectively drive system reform. Today, there are more than 250 Pay-for-Performance (P4P) programs underway in the private sector and multiple Medicare Demonstration projects. An analysis of the P4P projects in markets across the country has shown that many discrete initiatives are underway within the same market, with limited coordination or dialogue between the sponsors.
There is reason to believe that if we follow our current course, the consequence will be increasing over-lapping and conflicting payment schemes.
