NCPA - National Center for Policy Analysis

A MODEL FOR HEALTH CARE THAT PAYS FOR QUALITY

November 7, 2007

Seeing low fees for family doctors as a weak link in the nation's health care system, some big employers and health insurers are seeking new ways to pay doctors to reward high-quality medical care, says the New York Times.

One such idea is being presented by the National Committee for Quality Assurance, a nonprofit organization focused on health care.  Under their model:

  • Doctors would be encouraged to meet with patients for more than a few minutes during office visits and increase communication with patients by phone and e-mail outside office hours.
  • Doctors would also be compensated for helping patients manage chronic conditions -- like reminding diabetic people to take their insulin -- and would be encouraged to transmit prescriptions electronically.
  • The doctors, in turn, would be paid for more services than are currently reimbursed under typical health plan payments for office visits.

Health policy experts say that payment and practice rule changes -- like the one outlined above -- are needed to avoid a financial squeeze on primary care doctors, who are already becoming scarce in many parts of the country.

Fortunately, experiments based on the proposed model have been successful so far.  Tests with employers like Boeing, and several Blue Cross plans, indicate that money can be saved -- and funneled back to primary care -- by helping patients deal with conditions like diabetes, asthma and heart conditions by avoiding emergency room visits and hospital admissions.

Source: Milt Freudenheim, "A Model for Health Care That Pays for Quality," New York Times, November 7, 2007.

For text:

http://www.nytimes.com/2007/11/07/business/07care.html 

 

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