Payment Reform: No Government Mandate Needed

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The move in the health sector towards payment reform took a big leap forward as 1,800 doctors at Beth Israel Deaconess Medical Center signed a global budget contract with Blue Cross for HMO patients.

In other words, doctors are given a fixed budget for the care for each patient during that year. Supporters of global payments hope that the quality of care will be improved.

WBUR’s CommonHealth Blog posted an interview with Dr. Stuart Rosenberg about the move. What I found especially interesting was Dr. Rosenberg’s statement at the end of the video. 4:40

My idea is let’s just get on with the solution, and not wait for the government to pass a law.

During a radio story carried on NPR, the CEO of Harvard Pilgrim, Eric Schultz, is quoted saying that insurers are currently “tailoring” contracts in order to work with providers that want to take on risk to manage a health care budget.

He warns however that, “What we don’t want to do is think there is one model that can be applied to every clinical care delivery system…If we do, we will all fail and we will lose a really great policy idea because we tried to apply it too fast or too broadly.”

These types of reports should raise many challenging questions about global payments and accountable care organizations– but putting those aside for a moment– locally it raises a basic question for policymakers:

Will those on Beacon Hill see the trends in the private sector towards payment reform and utilize a light hand in the upcoming payment reform debate? Or as many fear, resort to heavy handled bureaucratic methods to force providers into these contracts and potentially enforce static reimbursement rates?