It didn’t get much press (actually, did it get any press?), but there was some interesting testimony during yesterday U.S. Senate Committee on Finance hearings concerning healthcare delivery system reform. Two highlights:
Mark Miller, executive director, Medicare Payment Advisory Commission: “The health care delivery system we see today is not a true system: care coordination is rare, specialist care is favored over primary care, quality of care is often poor, and costs are high an increasing at an unsustainable rate. Part of the problem is that Medicare’s fee-for-service (FFS) payment systems create separate payment ‘silos’ (e.g., inpatient, physician). They do not encourage coordination among providers…Medicare has not been the sole cause of the problem, nor should it be the only participate in the solution. Other private and public payers will need to change payment systems as well to bring about the conditions needed to change the broader health care delivery system.”
Glenn Steele, M.D., chief executive, Geisinger Health System: “A great paradox in healthcare is that we get paid for making more mistakes. It doesn’t mean that we intentionally make mistakes, but we are frequently rewarded financially when an outcome is not beneficial to the patient. For example, with few exceptions, if a patient develops a post-operative complication that might have been avoided by proper care, we may receive more reimbursement for that case than for a comparable case without a complication. This does not happen in other industries. Purchase of a car, a computer or even a home typically includes a warranty. Why should healthcare services be an exception?”
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