In Closing Months, The Obama Administration Wants to Revolutionize How Health Care Is Paid For

To complement the Affordable Care Act, the Obama Administration has been working on “an equally sweeping project to transform the way America’s doctors, hospitals and other medical providers deliver care,” The Los Angeles Times reports.

“The foundation of this effort involves scrapping the way medicine has traditionally been paid for – a system akin to auto repair in which each service a doctor or hospital provides is billed separately, no matter how well it is performed and what the long-term outcome is.”

“In place of that, the Obama administration is trying to build a system that pays doctors, hospitals and others based on how their patients recover and how much their care costs.”

Health and Human Services Secretary Sylvia M. Burwell told the Times, “The Affordable Care Act was about so much more than coverage… We have to broaden the concept. The increased access is tremendous, but health outcomes are the place where we have to make historic changes.”

“Financial incentives will cause better coordination of care. That will lead to better quality and lower costs.”

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  • Calbengoshi

    Although there are some aspects of medicine where the outcome is dependent on the medical provider, in many situations the outcome also depends on the patient. Doctors can recommend lifestyle changes to improve one’s health (e.g., stop smoking, exercise more, eat less, etc.), but cannot force their patients to comply with those recommendations. Similarly, in a post-operative situation, some patients follow a doctor’s advice carefully and others follow it somewhat or hardly at all. I also think it will be interesting to see how one evaluates the “outcome” of a doctor’s treatment of an illness for which there is no cure.

    • nanotab

      Re “outcome” of a doctor’s treatment of an illness for which there is no cure: A typical one is how long the patient lives after the “treatment”. E.g., 1-, 3-, 5-year survival rates for treatments for a type of cancer with very poor prospects. I realize that one might also want to measure other things (e.g., pain) that are a lot harder to measure, and it would be good to try to develop such measures.

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