Mr. Bardis explained some of the forces that lead to where we are today: Medicare payment structures, cost-shifting and a lack of pricing transparency. The rising cost of healthcare has also hurt the economy, he argues. “American businesses continue to offload health insurance risk to individual employees,” he wrote, noting healthcare insurance premiums rose 8 percent for individual plans and 9 percent for family plans in 2010 alone.
“The need to rethink the payment structure is clear,” said Mr. Bardis, explaining that paying for results is the best way to lower costs. “After all, when we buy a car, we buy based on capabilities; not on delivery of the car itself,” he wrote. He goes on to explain some burgeoning efforts by CMS to reward high-quality care, and encourages providers to participate in optional reimbursement programs that do just this, saying:
“To those on the sidelines, I say ‘This train has left the station.’ Commercial payors are ahead of CMS and already are using this methodology. Many providers today need to manage simultaneously fee-for-service models and various forms of value-based reimbursement.”
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