Leaders in health care and healthcare policy feel strongly that the way we pay for health care in the U.S. must be fundamentally reformed. The latest Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey reports that more than two-thirds (69%) of respondents expressed strong dissatisfaction with the current system, which is generally based on “fee-for-service” payment, saying the current system is not effective in encouraging high quality and efficient care.
The current fee-for-service system reimburses individual services--hospital stays, physician visits, and procedures--rather than paying for the most appropriate care for the patient over the course of an illness or a time period. In doing so, it creates incentives to provide more technical and more expensive services, rather than encouraging more effective, higher-value care. Only one percent of healthcare leaders surveyed said they preferred the current fee-for-service payment system to alternative approaches.
There was strong support for a move away from fee-for-service payment toward bundled approaches, which make a single payment for all services provided to a patient during the course of an episode or time period. When asked about preferred options for payment reform, 53 percent of opinion leaders chose a blend of modified fee-for-service and bundled per-patient payment, while another 23 percent chose bundled per-patient payment alone.
