Opinion Leaders Survey: New Method Needed for Setting Health Care Payment Rates

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<p>In the latest Commonwealth Fund/<em>Modern Healthcare </em>Health Care Opinion Leaders Survey, experts voice support for moving away from the current method of negotiating health care payments and toward all-payer rate setting, in which a government authority sets the rates, or an all-payer system of jointly negotiating rates for all payers.</p>
<p>The survey's findings are discussed in a <a href="/publications/publication/2010/oct/health-care-opinion-leaders-views-transparency-and-pricing">Commonwealth Fund data brief</a> published today.</p>
<p>Currently, health care payment rates are set through a complex system in which public and private health insurers each engage independently with multiple health care providers to negotiate or set payment rates with hospitals and physicians. Replacing this system with all-payer rate setting or joint rate negotiation could help reduce excess administrative expenses and wide variation in prices, note Commonwealth Fund researchers Kristof Stremikis, Karen Davis, and Stuart Guterman, the authors of the data brief. Only 9 percent of survey respondents were in favoring of maintaining the current system. </p>
<p>Opinion leaders also voiced broad support for creating a standard method of rewarding quality and efficiency across private insurers and public payers. More than seven of 10 feel it is important or very important for all payers to use the same basic method of rewarding providers, which may be an effective way of improving patient outcomes, reducing wasteful administrative expenses, and lowering costs.</p>
<p>"The way we currently pay for health care leads to unnecessary confusion and wide variation, and sometimes borders on chaotic," said Commonwealth Fund President Karen Davis. "Experts agree that if private payers and public programs could come together and agree to pay the same way, and the same amount, we can improve the efficiency of our health care system, eliminate administrative waste, and create better experiences for patients."</p>
<p>Also published today on commonwealthfund.org are Fund Blog posts by <a href="/blog/2010/time-unmask-price-differences-health-care">Louise Probst</a>, executive director of the St. Louis Area Business Health Coalition, and <a href="/blog/2010/transparency-and-consumer-education-needed-health-reform-success">Barbra G. Rabson</a>, executive director of Massachusetts Health Quality Partners, who discuss issues surrounding transparency of pricing information and quality of care. </p>