To control costs and improve quality, physicians should advocate and participate in integrated accountable care organizations, according to leading industry analysts writing in The New England Journal of Medicine.
Elliott Fisher, associate director of the Dartmouth Institute for Health Policy and Clinical Practice; Donald Berwick, president and CEO of the Institute for Healthcare Improvement; and Karen Davis, president of the Commonwealth Fund, write that healthcare cost savings must come from placing accountability for care coordination with integrated organizations comprising virtually linked networks of independent practicioners or more traditional multispecialty groups or staff-model HMOs. They acknowledge that such organizations will require change in current gainsharing and antikickback laws and regulations.
Fisher, Berwick, and Davis further suggest that physicians reassess and scale back practices that research shows are overused and "agree to slow fee increases for private payers, allowing Medicare to catch up." The analysts also suggest that a legislative target may be necessary in order to bring costs under control, including federal government "authority to reduce updates in Medicare fees if the target [rate of spending growth] is exceeded."
Karen Davis is leading a panel of provider executives to discuss creating a high-performing health system at HFMA's ANI: The Healthcare Finance Conference next month in Seattle.
