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Randy Appleton
Randy Appleton
Attorney • (800) 752-0042

Rethinking Compensation In The American Healthcare System

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A recent Wall Street Journal editorial discussed the urgent need for Americans to rethink the way they pay doctors for their services. The trick, according to the opinion piece, is exactly how to make the changes.

Currently, most doctors are paid for the services they perform, but one component of the President’s healthcare proposal is to overhaul the way doctors are reimbursed, basing payments on healthcare outcomes rather than services rendered. Part of the plan includes setting aside a certain percentage of Medicare payments so doctors are paid for those claims based on patient-satisfaction surveys and grades they received for compliance with standard patient care procedures.

Supporters of efforts to change the current payment practices say the existing system incentivizes doctors to simply perform medical procedures round the clock. By paying per service, quantity is rewarded above quality. This means some patients are subjected to additional and unnecessary tests or hospitalizations in the interest of padding a doctor’s bottom line. By more closely aligning patient healthcare outcomes with doctor pay, doctors and hospitals would have an increased incentive to ensure that each patient truly does receive the best care money can buy.

Another variation of this pay-for-quality approach is to pay doctors a single payment for all of the care a patient who has a certain condition needs. This is increasingly seen as a viable approach for things like knee replacement procedures, heart bypass or cardiac stents. That would mean that if a patient is ever readmitted after a surgical procedure, the doctor would not receive any extra payment for the procedure. The hope is this approach would encourage doctors to avoid complications by not compensating them for future procedures.

Though many agree the current system needs to be rethought, some in the medical world have expressed concern at the idea of paying for performance. The opponents have said that while the current system needs to be fixed, pay for performance won’t work because there are too many opportunities for doctors to cheat the system.

While there may be some thorny issues involved in the creation of a pay for performance system, it’s an important task that many agree is worth pursuing. Paying doctors for the quality of the care they provide is an opportunity to totally rethink the way the medical field operates and would hopefully help minimize dangerous negative healthcare outcomes.

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