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Survey finds widespread dissatisfaction with current health care payment system
Date:11/3/2008

New York, N.Y., November 3, 2008Leaders in health care and health care policy feel strongly that the way we pay for health care in the U.S. must be fundamentally reformed. The latest Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey reports that more than two-thirds (69%) of respondents expressed strong dissatisfaction with the current system, which is generally based on "fee-for-service" payment, saying the current system is not effective in encouraging high quality and efficient care.

The current fee-for-service system reimburses individual serviceshospital stays, physician visits, and proceduresrather than paying for the most appropriate care for the patient over the course of an illness or a time period. In doing so, it creates incentives to provide more technical and more expensive services, rather than encouraging more effective, higher-value care. Only 1 percent of health care leaders surveyed said they preferred the current fee-for-service payment system to alternative approaches.

The survey asked respondents their opinions about various policy strategies for improving U.S. health system performance. Eighty-five percent of respondents believe fundamental provider payment reform with incentives to provide high-quality and efficient care over time is an effective strategy. Similarly, a majority of leaders deemed bonus payments for high-quality providers (55%) and public reporting of information on provider quality and efficiency (53%) as effective or very effective strategies for improving performance.

There was strong support for a move away from fee-for-service payment toward bundled approachesthat is, making a single payment for all services provided to a patient during the course of an episode or time period. When asked about preferred options for payment reform, 53 percent of opinion leaders chose a blend of modified fee-for-service and bundled per-patient payment, while another 23 percent chose bu
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Contact: Mary Mahon
mm@cmwf.org
212-606-3853
Commonwealth Fund
Source:Eurekalert

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