Moving Toward A More Rational Payment System
The fee-for-service (FFS) payment system is increasingly seen as a barrier to effective, coordinated, and efficient care. FFS rewards the overuse and duplication of services, as well as costly, specialized treatment. Moreover, it does not reward providers for keeping patients from being hospitalized, or rehospitalized, or for helping patients control and monitor their chronic conditions. In exploring alternatives to FFS, Davis examines approaches that base payment on the total care a patient receives during an episode of illness or a defined period. Another option is basing payment around the concept of a "medical home," in which patients receive accessible, continuous, and coordinated care from a physician or practice. Extensive evaluations of these new methods are vital, Davis says, to help providers and patients move toward a more rational payment system that rewards coordination and efficiency, while slowing the escalating costs of health care. K. Davis (2007) Paying for Care Episodes and Care Coordination. The New England Journal of Medicine 356, 1166–1168.
The fee-for-service (FFS) payment system is increasingly seen as a barrier to effective, coordinated, and efficient care. FFS rewards the overuse and duplication of services, as well as costly, specialized treatment. Moreover, it does not reward providers for keeping patients from being hospitalized, or rehospitalized, or for helping patients control and monitor their chronic conditions. In exploring alternatives to FFS, Davis examines approaches that base payment on the total care a patient receives during an episode of illness or a defined period. Another option is basing payment around the concept of a "medical home," in which patients receive accessible, continuous, and coordinated care from a physician or practice. Extensive evaluations of these new methods are vital, Davis says, to help providers and patients move toward a more rational payment system that rewards coordination and efficiency, while slowing the escalating costs of health care. K. Davis (2007) Paying for Care Episodes and Care Coordination. The New England Journal of Medicine 356, 1166–1168.