The stand-alone fee-for-service payment could disappear by the end of the decade if a plan newly released by the National Commission on Physician Payment Reform is followed.
The stand-alone fee-for-service payment could disappear by the end of the decade if a plan newly released by the National Commission on Physician Payment Reform (NCPPR) is followed. The commission's members have issued a report they say details a series of sweeping recommendations aimed at reining in health spending and improving quality of care by fundamentally changing the way doctors are paid.
Chaired by former Robert Wood Johnson Foundation president Steven A. Schroeder, MD, with former Senator Majority leader Bill Frist, MD, as honorary chairman, the NCPPR is urging a transition over 5 years to a blended payment system that it says will yield better results for both public and private payers, as well as patients.
“We can’t control runaway medical spending without changing how doctors get paid,” Dr. Frist says. “This is a bipartisan issue. We all want to get the most from our healthcare dollars, and that requires re-thinking the way we pay for healthcare.”
“The way we pay doctors is profoundly flawed,” says Dr. Schroeder, who is the Distinguished Professor of Health and Healthcare at the University of California, San Francisco. “We need to move rapidly away from fee-for-service and embrace new ways of paying doctors that encourage cost-effective, high-quality care. The commission’s recommendations put us on that path.”
Initial steps in the commission's recommendations include fast-tracking new models of care, such as accountable care organizations and Patient-Centered Medical Homes, which reimburse doctors through fixed payments and shared savings, and adopting bundled payments for patients with multiple chronic conditions and in-hospital procedures and their follow-up.
Fee-for-service will remain an important mode of payment into the future, according to the commission's report, which maintains that bundled payments and other fixed payment models are not a panacea; many of these models still pay individual physicians on a fee-for-service basis. As such, the commission put forth several recommendations for recalibrating fee-for-service payment to fix payment inequities and reward care that improves patients’ health.
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