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ASU experts say US needs to shift healthcare emphasis to pay for value
Date:12/12/2012

Smoldt said. "We get more services because we order more services and somebody else pays for them. Does that make us healthier? Not really."

In order to change this, Cortese and Smoldt say three things need to happen: we need to pay for value, provide insurance for all, and implement greater integration and coordination among providers and payers.

Pay for value

Valuable healthcare is healthcare that provides good patient outcomes while using fewer resources. Today, in the U.S. that is not the case. Cortese said Medicare currently does not routinely pay for nurse provided care. In fact, it is a non-reimbursable expense for both Medicare and Medicaid.

"We couldn't even have nurses interacting with kids at school who have asthma and find a way to get them paid under the current system," he said. "We get much more money if we wait for the kids to get sick, hit the emergency room and then get admitted to the hospital. That is how everybody makes money today."

Likewise home healthcare services are not covered, so if the best way to care for a particular patient is to provide home health services maybe with a nurse going into the home nobody pays for that," Cortese said. "The payment mechanism only pays when you are sick. There is no payment to keep you healthy."

"If we really want something to happen in healthcare, we have to start paying for value not just for services," Cortese emphasized.

He added that Medicare needs to be the driving force in making paying for value an accepted practice.

Medicare is the largest payer for care in the U.S., so "it has a big influence on the way we practice," Cortese said. "With the new healthcare bill there are opportunities for them to begin some new pilot programs and begin to change the way we are being paid."

Insurance for all

The Affordable Care Act should expand healthcare coverage in the U.S. Lack of insurance is a contributing fa
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Contact: Skip Derra
skip.derra@asu.edu
480-965-4823
Arizona State University
Source:Eurekalert

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