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

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 the Heller School for Social Policy and Management, Brandeis University.

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 recently published article in the Sept. issued 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 regarding payment reform 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󈟀. 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.

Robert 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 twenty-one 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, DC-based health care consulting firm. He is currently a trustee of Atrius Health, a 1,000-physician multispecialty group practice.

His co-author, Darren 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.


Contact: Susan Chaityn Lebovits
Brandeis University

Related medicine news :

1. Smokers Drop Pricey Cigarettes for Cheaper Alternatives: CDC
2. Payment innovation cuts depression time in half
3. Study examines federal government payments to separate managed care programs for same patients
4. Global Budget Payment Model lowers medical spending, improves quality
5. Revised geographic adjustments could improve accuracy of Medicare payments, will not solve access, quality problems
6. Internists express support for new payment and delivery models as basis for replacing SGR
7. Internists say physician-led quality initiatives could be solution to Medicare payment problems
8. IU, Regenstrief automated system aims to improve child health
9. Scientists tailor cell surface targeting system to hit organelle ZIP codes
10. Physicians call for improvements to countrys public health system to protect US residents
11. New research finds no association between white potato consumption (baked, boiled mashed) and obesity, Type 2 diabetes or systemic inflammation
Post Your Comments:
(Date:11/27/2015)... ... November 27, 2015 , ... The print component ... Today in Atlanta, Dallas, New York, Minneapolis, South Florida, with a circulation of ... distributed nationally, through a vast social media strategy and across a network of ...
(Date:11/27/2015)... Wilmington, DE (PRWEB) , ... November 27, 2015 ... ... a member of the well-respected Microsoft Dynamics SL User Group (MSDSLUG). Recognized as ... is an independent group of Microsoft Dynamics SL software users, partners, industry experts ...
(Date:11/27/2015)... ... November 27, 2015 , ... CBD College is ... Health Education Programs (CAAHEP) awarded accreditation to its Diagnostic Medical Sonography program. CBD College ... as only one of twelve colleges and universities in the state of California make ...
(Date:11/27/2015)... , ... November 27, 2015 , ... ... center software Q-Suite, announces the incorporation of Asterisk 11 LTS (Long Term Support) ... supported Asterisk 11 LTS brings Q-Suite 5.10 up-to-date with a version of Asterisk ...
(Date:11/26/2015)... ... November 26, 2015 , ... ... Travel Representative. As a franchise owner, Somu now offers travelers, value and care ... wedding packages, private cruise sales, as well as, cabin upgrades and special amenities ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... November 26, 2015 ... the "Radioimmunoassay Market by Type (Reagents ... Industry, Academics, Clinical Diagnostic Labs), Application (Research, ... to 2020" report to their offering. ... the addition of the "Radioimmunoassay Market ...
(Date:11/25/2015)... WASHINGTON , Nov. 25, 2015  The ... Obstetricians and Gynecologists (ACOG), and the March of ... bipartisan Protecting Our Infants Act of 2015 ... the number of newborns born exposed to drugs, ... Since the bill,s introduction, all three organizations have ...
(Date:11/25/2015)... MELVILLE, N.Y. , Nov. 25, 2015  Henry ... products and services to office-based dental, medical and animal ... Dental (GNYDM) Meeting the Henry Schein ConnectDental® Pavilion ... industry,s broadest array of open solutions designed to help ... Click here for a schedule of ...
Breaking Medicine Technology: