The Globe’s Liz Kowalczyk reports on a recommended retreat from fee-for-service payments. Sound familiar? HMOs tried the payment-per- patient approach in the ’80 and ’90, with little success. Maybe the state can do it right this time. It is true — the way we pay for health care now encourages inefficiencies, poor care and high costs.
A single, yearly fee is intended to discourage doctors and hospitals from providing unneeded tests and treatments, so patients could find it harder to get procedures of questionable benefit. And because doctors and hospitals would have to work together more closely to manage the budget, the hope is they will better coordinate care for patients, which could improve quality.
The “fee-for-service” system “has all the wrong incentives,” said Dolores Mitchell, a member of the Special Commission on the Health Care Payment System and head of the state employees’ insurance program. “It encourages excessive use and does nothing to discourage waste. People know the system has been dysfunctional for years.”