I recently met with hospital leaders in North Carolina and across the nation to talk about health care reform. As a member of the American Hospital Association’s task force on payment reform, we spent much of our time discussing how reform will likely change the way hospitals and other health care providers are paid (or not paid) for the care they provide.
The new payment structure we’re discussing will be designed to focus on the quality of care, instead of the amount of health care services provided. Currently the nation employs a fee-for-service model where providers are paid for each service they deliver. The AHA task force is devoting a good amount of time discussing the concept of bundling of payments – where all providers involved in a patient’s care will be paid one flat fee on an “incident of care” basis. This bundling, as proposed by the government, would encourage teamwork among health care providers, improve cost efficiency and enhance health care quality and safety. Equally important, it will allow for better distribution and use of existing resources and therefore improve the access to care.
As a first step, we have identified several recommended guidance principles to help ensure that all health care providers across the nation are fairly compensated. This includes figuring out how to handle the differences between various markets, types of institutions and physician practices and payment populations. It’s important for our nation to create a sustainable model that will work for physicians and, of course, hospitals of all types: rural hospitals that treat fewer patients, inner city hospitals that primarily care for low-income or uninsured patients and large non-profit hospital systems like WakeMed.
The AHA task force still has quite a way to go because the national health care system is extremely complex, but when the work is complete, I will share with you a copy of the task force’s final observations and recommendations related to nation-wide reform.