The main tension about healthcare centers around medical need, quality, access and cost-efficiency, i.e., affordability.To increase "value," one must raise quality, improve access and/or lower the cost of care. The latter, however, is an elusive goal; it is the elephant in the room.
Paying healthcare practitioners fairly is the crux of healthcare payment reform. Here is a brief synopsis of how methods to reign in physician compensation have always failed is that nothing has worked.
A physician gets milked! Consider what happened to me....
Medical research has largely been focused on curative medicine–"medicine yielding better drugs, medical devices, and clinical procedures. [Where as] Prevention science—the systematic application of scientific methods to the causes and prevention of diseases in populations—has yet to receive the necessary investment and support required to reduce the growing burden of largely preventable noncommunicable diseases (NCDs)."1
The Commonwealth Fund contends that: reforms physicians could champion to eliminate waste and duplication (inefficiency) include, but are not limited to: "integrated systems of care,""shared savings, bundled payments, or global fees" and "performance measures that promote care coordination." I say that docs aren't happy about any of that. I can hear them now.... Here's what i hear docs saying with regard to Affordable, Accountable, or Managed Care: I'm too expensive?
Identifying potentially preventable readmissions obeys Willie Sutton's Law. But, will you put all your eggs in that basket?
Who's not anxious to improve health care's Cost/Quality/Access lest they be left out?
When addressing possible administrative sanctions, an effective compliance program (CP) can protect physicians, so long as it was in place predating any investigation.
Francis J. Crosson, MD seeks "a rationale designed to influence the physician microenvironment so as to support physicians in developing patterns of clinical decision making that result in better health outcomes and lower costs."
This Website discusses how to be successful at 'managing' care, but, as a fellow Medical Director and I wrote in 1994,