Check out a great case study of  Mount Auburn Hospital and the Mount Auburn Cambridge IPA in the current issue of Health Affairs.

The report suggests that Massachusetts, which is considering global payments to replace fee-for-service medicine for all payers in the state, may have found the way to align physicians’ and hospitals’ financial interests with those of the payers. However, patients have not yet been brought into the alignment:

…since patients don’t pay more if they seek care outside Mount Auburn, they face no disincentive to go outside the system—even though a new doctor or hospital may repeat tests or miss something in the patient’s history or prescription list.