Health Care Payment Reform

Mayo Clinic supports the Senate health reform bill but seeks more action on how care is paid For, as per today’s Wall Street Journal.

Physicians and patients both may benefit from the launch of a new database that informs the rates that health plans will pay for out-of-network services.

The successor to the Ingenix database is expected to emerge in mid-year.

Writing in a web-first article in  Health Affairs, Dr. Robert Wachter,  professor and associate chair of the Department of Medicine at the University of California, San Francisco, reviews the past decade of patient safety and gives it a B- score.

In updating a five-year review, Wachter examines the role of health care payment in promoting patient safety:

The “no pay for errors” policy, launched in 2008, has increased hospitals’ focus on preventing certain adverse events (despite relatively trivial payment cuts to date). However, concerns have beenraised about fairness (particularly since many of the events on the list are not known to be substantially preventable)  and unintended consequences (such as keeping hospitalized elderly patients in bed in a misguided effort to prevent falls).

For now, I give this category a C+, with some points awarded to Medicare’s new policy for being a clever way to begin reshaping the reimbursement system to promote patient safety.