Health care costs too much, and the chorus of disapproval laments the 17.8 percent of the nation's Gross Domestic Product spent on health care. So what would happen if healthcare providers were liberated from the reliance on payments that reward doing more, regardless of outcome? By declaring fee-for-service dead, we could enjoy the birth of a new era of health-focused care that is person-centered, efficient, and equitable, and results in outcomes that promote or restore health.
Providers would be encouraged to focus more on prevention and work in partnership with communities where people live, work, and play, to address the social and behavioral determinants that drive health and disease. Access to care tops that list, along with factors such as literacy, safe neighborhoods, clean water, nutritious food, resources to meet daily needs, a physical environment free of barriers and hazards, and health-promoting behaviors. Social issues left unaddressed manifest as health problems. Together, these issues create the chronic disease burden which robs people of their quality of life, and threatens the economy.
Health system transformation requires a partnership between the government and private sector for cost-sharing that stimulates the economical use of health care services while supporting those who do not have the means to share in costs.Advancing a payment system that rewards quality and the appropriate, effective use of resources also is essential. Many agree that the momentum for value-based payments is unstoppable and should be a fundamental part of any health policy reform proposal. To accelerate more effective use of resources, payments must align with the right dose of care.