Robert Wood Johnson report calls for healthcare payment reform

Healthcare is so expensive in the United States because we don't reimburse doctors and hospitals intelligently, according to a new report by the nonprofit Network for Regional Healthcare Improvement.

The U.S. healthcare payment system is built to reward the quantity of treatment, not the quality, says the report, From Volume to Value: Transforming Health Care Payment and Delivery Systems to Improve Quality and Reduce Costs.

This backward payment system penalizes doctors and hospitals financially for eliminating unnecessary tests and treatments, preventing infections and keeping people healthy.

The report resulted from a summit of more than 100 leaders from across the United States, including physicians, hospitals, insurers, academics, foundations, government and regional healthcare collaboratives. Summit attendees endorsed a profound transformation in the way hospitals, doctors and other healthcare professionals are paid.

"We can help lift the quality of healthcare by fixing the way we pay for it," said Michael W. Painter, MD, a senior program officer at the Robert Wood Johnson Foundation, which funded the summit and the report. "We need to quit paying for things that don't work - like unnecessary and even dangerous tests and treatments - and pay for things that we know do work, like helping patients better manage their chronic illnesses."

The report recommends that insurers pay physicians and hospitals a single amount that covers all the services a patient needs instead of separate fees for each service. Moreover, insurers should change the system from paying more to correct errors and preventable complications to rewarding providers for successfully treating patients.

The report also addresses ways to encourage patients to use higher-quality, lower-cost doctors and hospitals; how to protect patients from receiving too few services; and how to help healthcare providers change to new payment systems and lower-cost care.


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