Featured Research

from universities, journals, and other organizations

Alternatives to Medicare's fee-for-service payment system examined

Date:
September 5, 2012
Source:
Brandeis University
Summary:
For years policymakers have attempted to replace Medicare's fee-for-service payment system with approaches that pay one price for an aggregation of services. The intent has been to reward providers for offering needed care in the most appropriate and cost-effective manner. But many of these programs have known pitfalls, according to a new article.

For years policymakers have attempted to replace Medicare's fee-for-service payment system with approaches that pay one price for an aggregation of services. The intent has been to reward providers for offering needed care in the most appropriate and cost-effective manner. But many of these programs have known pitfalls, says Stuart Altman, an economist and the Sol C. Chaikin Professor of National Health Policy at Brandeis University's Heller School for Social Policy and Management.

On Friday, Sept. 7, Altman and his Heller school colleague Robert Mechanic will take part in a briefing at the National Press Club in Washington, D.C., sponsored by the journal Health Affairs. Altman will discuss his article published in the September issue of Health Affairs: "The Lessons Of Medicare's Prospective Payment System Show That The Bundled Payment Program Faces Challenges."

This edition of Health Affairs, entitled "Payment Reform To Achieve Better Health," is specifically devoted to current and future challenges surrounding payment reform in health, specifically examining current and future challenges in the U.S. health care system.

Altman has been involved in debates over U.S. health reform since the 1970s, when he was deputy assistant secretary for planning and evaluation/health at the Department of Health, Education, and Welfare, which later became the Department of Health and Human Services. In 1977 President Bill Clinton appointed Altman to the National Bipartisan Commission on the Future of Medicare.

Altman's article provides a detailed analysis of how Medicare implemented the hospital prospective payment system, how hospitals responded to the new incentives, and lessons learned that are applicable to the bundled payment initiative. These lessons include that any Medicare payment reform needs to respond to the many different elements of the health system, and that payment reform should be coupled with reforms in private insurance payment.

Medicare's first payment change was the hospital prospective payment system, introduced during 1983-84. But because it focused only on hospital care, its impact on total Medicare spending was limited.

In 2011 Medicare began a new initiative to expand the "bundled payment" concept to link payments for multiple services that patients receive during an episode of care. The goal of Medicare's current bundled payment initiative is to provide incentives to deliver health care more efficiently while maintaining or improving quality.

Mechanic, a senior fellow at the Heller School for Social Policy and Management, along with Darren Zinner, a social scientist at the Schneider Institute for Health Policy and a senior lecturer at the Heller School, have also published an article in the September issue of Heath Affairs. The article, entitled "Many Large Medical Groups Will Need To Acquire New Skills And Tools To Be Ready For Payment Reform," is a survey study regarding the readiness of medical groups for payment reform, particularly reform which holds health systems accountable for delivering care under predetermined budgets to help control spending. The article also addresses improvements that medical groups might make to advance their readiness for payment reform. Mechanic and Zinner surveyed 21 large, multispecialty groups and list their findings within the study.

Mechanic was previously a senior health care analyst with Forrester Research and a senior vice president of the Massachusetts Hospital Association. From 1988 to 1998 he was a consultant and vice president with the Lewin Group, a Washington, D.C.-based health care consulting firm. He is currently a trustee of Atrius Health, a 1,000-physician multispecialty group practice.

Zinner is a senior member of Brandeis University's Health Industry Forum, in addition to being a social scientist and lecturer. His research focuses on the management and structure of the U.S. scientific enterprise, especially on how funding for and the organization of scientific teams affects productivity and outcomes.


Story Source:

The above story is based on materials provided by Brandeis University. Note: Materials may be edited for content and length.


Journal Reference:

  1. S. H. Altman. The Lessons Of Medicare's Prospective Payment System Show That The Bundled Payment Program Faces Challenges. Health Affairs, 2012; 31 (9): 1923 DOI: 10.1377/hlthaff.2012.0323

Cite This Page:

Brandeis University. "Alternatives to Medicare's fee-for-service payment system examined." ScienceDaily. ScienceDaily, 5 September 2012. <www.sciencedaily.com/releases/2012/09/120905171634.htm>.
Brandeis University. (2012, September 5). Alternatives to Medicare's fee-for-service payment system examined. ScienceDaily. Retrieved August 21, 2014 from www.sciencedaily.com/releases/2012/09/120905171634.htm
Brandeis University. "Alternatives to Medicare's fee-for-service payment system examined." ScienceDaily. www.sciencedaily.com/releases/2012/09/120905171634.htm (accessed August 21, 2014).

Share This




More Health & Medicine News

Thursday, August 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Newsy (Aug. 21, 2014) An experimental drug used to treat Marburg virus in rhesus monkeys could give new insight into a similar treatment for Ebola. Video provided by Newsy
Powered by NewsLook.com
Cadavers, a Teen, and a Medical School Dream

Cadavers, a Teen, and a Medical School Dream

AP (Aug. 21, 2014) Contains graphic content. He's only 17. But Johntrell Bowles has wanted to be a doctor from a young age, despite the odds against him. He was recently the youngest participant in a cadaver program at the Indiana University NW medical school. (Aug. 21) Video provided by AP
Powered by NewsLook.com
American Ebola Patients Released: What Cured Them?

American Ebola Patients Released: What Cured Them?

Newsy (Aug. 21, 2014) It's unclear whether the American Ebola patients' recoveries can be attributed to an experimental drug or early detection and good medical care. Video provided by Newsy
Powered by NewsLook.com
Lost Brain Cells To Blame For Sleep Problems Among Seniors

Lost Brain Cells To Blame For Sleep Problems Among Seniors

Newsy (Aug. 21, 2014) According to a new study, elderly people might have trouble sleeping because of the loss of a certain group of neurons in the brain. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins