Payment Reform to Achieve Better Health Care

Health Affairs Thematic Issue

This is archived content; for historical reference only.

A CHCF-sponsored issue of Health Affairs assesses new approaches to pay providers for their services that align incentives and reduce costs.

CHCF has made the following articles from the issue available online at no charge:

  • “A Global Budget Pilot Project Among Provider Partners and Blue Shield of California Led to Savings in First Two Years” describes a new financial risk arrangement for providers that uses an annual global budget. Written by Paul Markovich, president of Blue Shield of California, this article describes the results of a payer-provider partnership (structured as an accountable care organization, or ACO) piloted in Sacramento.
  • “Fee-For-Service Will Remain a Feature of Major Payment Reforms, Requiring More Changes in Medicare Physician Payment,” by Paul Ginsburg, president of the Center for Studying Health System Change, reviews the history of the current physician payment system and highlights areas that require careful review and modification to ensure the success of broader payment reform.
  • “Payers Test Reference Pricing and Centers of Excellence to Steer Patients to Low-Price and High-Quality Providers” compares two benefit designs with respect to patient choice, cost, and quality. This article examines the impact of new benefit designs on patient coverage and cost sharing and was written by James Robinson, professor of health economics, and Kimberly MacPherson, health policy and management program director, at the University of California, Berkeley.
  • “Introducing Decision Aids at Group Health Was Linked to Sharply Lower Hip and Knee Surgery Rates and Costs” by, among others, David Arterburn, associate investigator at Group Health Research Institute, provides evidence that decision tools reduce rates of elective procedures and lower costs.
  • “Providers’ Payment and Delivery Systems Reforms Hold Both Threats and Opportunities for the Drug and Device Industries,” by Robinson, describes how payment reforms might impact the medical technology industry and outlines opportunities for adaptation.

In an accompanying blog post, Dr. Mark Smith, founding president and CEO of CHCF, explains why we should address payment reform in new ways. Dr. Smith believes the time is right to make a grand bargain with physicians: They can maintain either their traditional role, payment methods, and scope of practice or their income, but not both.

The blog post and five articles are available free of charge on the Health Affairs site through the External Links below.