The American Hospital Association is examining how health care payment reform can actually happen. In an interview on the Health Affairs blog, AHA CEO Rich Umbdenstock says fee-for-service must go away in favor of some type of fixed payment.

A draft report has been prepared by a task force on payment reform:

And basically it doesn’t argue whether or not that’s the direction in which we’re headed.  What it examines is how we build the bridges to get from here to there.  And how can we figure out how it’s going to work in different communities because different communities are more or less integrated than one another already, and certainly the vast majority of communities are less integrated.

Exactly where payment is headed is not clear to AHA (or anybody), but the general direction is becoming obvious:

We do believe we’re going to move toward more of a fixed payment system, whether it’s bundled payments per procedure, or whether it’s something broader on an episode or time basis, or potentially all the way back to where we were in the nineties with capitation.