Commentary: health care payment reform and academic medicine: threat or opportunity?

Academic Medicine : Journal of the Association of American Medical Colleges
T Samuel Shomaker

Abstract

Discussion of the flaws of the current fee-for-service health care reimbursement model has become commonplace. Health care costs cannot be reduced without moving away from a system that rewards providers for providing more services regardless of need, effectiveness, or quality. What alternatives are likely under health care reform, and how will they impact the challenged finances of academic medical centers? Bundled payment methodologies, in which all providers rendering services to a patient during an episode of care split a global fee, are gaining popularity. Also under discussion are concepts like the advanced medical home, which would establish primary care practices as a regular source of care for patients, and the accountable care organization, under which providers supply all the health care services needed by a patient population for a defined time period in exchange for a share of the savings resulting from enhanced coordination of care and better patient outcomes or a per-member-per-month payment. The move away from fee-for-service reimbursement will create financial challenges for academic medicine because of the threat to clinical revenue. Yet academic health centers, because they are in many cases integrated health...Continue Reading

References

Oct 6, 2005·The Milbank Quarterly·Barbara StarfieldJames Macinko
Oct 13, 2005·JAMA : the Journal of the American Medical Association·Meredith B RosenthalArnold M Epstein

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Citations

Sep 17, 2010·Academic Medicine : Journal of the Association of American Medical Colleges·Michaela A DinanRalph Snyderman
Feb 13, 2014·Annals of Vascular Surgery·Jeffrey J SiracuseAndrew J Meltzer
Jul 23, 2011·AJNR. American Journal of Neuroradiology·C C Meltzer
Mar 2, 2011·Hospital Topics·Bethany Sneed LaneseRobert Figler
Apr 18, 2012·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Catherine A MarcoEric Bryant
Apr 7, 2018·Journal of Health Organization and Management·Alexandra EdelmanStephanie M Topp

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