Massachusetts health reform: A return to capitation?

mass-pcThe 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.”


One thought on “Massachusetts health reform: A return to capitation?

  1. This is nonsense! I am dealing with what I consider “elderly abuse” of my mother by a large Boston hospital. It is clear that she is subject to some sort of capitated payment system, though her Medicare plan does not indicate anything like that. She know nothing about it, of course. Like most elderly patients – she feels that her doctors have her best medical interests in mind. Little does she know that they seem to care more about their income than they do about her health.

    As a result, this hospital seems to be treating her in the cheapest way possible. And no, it is not working and there is no easy way to extract her from this mess without a legal battle. I can only imagine that they want her to drop dead and get them off the hook for her care. It disgusts me the way she is treated! What happened to “do no harm”? Has it been now changed to “… do no harm to your bottom line?”

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